Things I Learn from My Patients.

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rxlea said:
I liked when the patients in the pharmacy talked to me about anything and everything. I knew some by name and knew their family and stuff. I mean, it IS a healthcare setting. They should be able to talk about that stuff. I sorta think that community pharmacy has that advantage- because the pharmacist gets to know the patients, the patients might tell them stuff that they didn't tell their doctor (that they should have) and the pharmacists can catch stuff. They can see the progression of an illness over time as long as the patient is consistent with picking up scripts (and goes to the same pharmacy which DOESN'T happen with these stupid ass coupon things). It is an opportunity for the pharmacist to be directly involved in that patient's care. But, maybe I am just a weirdo for thinking that :shrug:
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maybe your pharmacy is different from the ones i've been to (i'm on the patient end) but i'd never consider them a healthcare setting (as in, somewhere where i was comfortable talking about my health). always a ton of strangers around that i wouldn't want knowing my business. if i had a private question or story, i'd prefer it be done in private. that may be possible at the places i've been to, but i doubt it with all the audience that always seems to be around when i'm there.
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rxlea said:
Actually, I would like rural very much. It was one of the things that drew me to UMN's program. It was hard to turn it down but Arizona has some rural "critical need" areas too so I am going to try to get into a rotation with IHS or something.
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Not that there's much difference between going to Duluth or TC, but Duluth does have the rural program option.
 
[YOUTUBE]http://www.youtube.com/watch?v=OeDekHY91dE[/YOUTUBE]

:laugh:
 
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When you ask the pharmacist for something OTC to treat a UTI and she goes to show you where the AZO is, it is necessary to inform her that you probably got a UTI because your husband likes to have anal sex, and he usually wipes his penis off before you engage in vaginal sex, except this time he didn't.
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It is a good idea to drop off 2 scripts (Adderall for you and Oxycontin for your "husband") on a Saturday and state that you tried to get it filled at Walgreens across the street, but they wouldn't fill it for you because you were in a wreck, and your ID got towed with your totaled car. When I tell you that I'm not filling your scripts because you're lacking ID, the RX pad you printed off of your home computer actually MISSPELLED THE DOCTOR'S NAME, and that I know that particular Dr.'s RX pad and handwriting (which is usually completely illegible, but somehow your script is magically written in beautiful cursive), the appropriate response would be to yell, "THAT'S BULL****," at me and storm out of the store with your scripts. (I should have just ripped them up in front of her, but I don't know if I'm allowed to without being able to contact the Dr. first.)

Fast forward a couple years...

It's an even better idea to come back to the same pharmacy and give the same person who called you out on presenting a fraudulent script before (and still remembers your face from 2 years ago) another script for Oxycontin, Roxicodone, and Xanax from a retired physician along with a driver's license that looks nothing like you (sorry if you're obese and have bad acne, you can't pass for a DL photo of someone that looks like Jessica Rabbit). Of course we won't find out he's retired when we call the verify your script right? (This time you were dumb enough to bring in your script before 5pm. Guess you were desperate.) The best part of your hairbrained scheme was bringing your 2 year old child strapped into a babyseat in the back along for the ride, so she had to watch her mother getting arrested, questioned, and searched by the narcotics division in the pharmacy parking lot.

Why the hell anyone would bring their chid on illegal errands is beyond me. I felt bad the kid had to experience that, but at the same time, she's probably better off not being subjected to her mother's ways. The funniest part was the cashier gave the kid a sucker right before the police swooped down on them.
 
By3Times1Minus1 said:
Why the hell anyone would bring their chid on illegal errands is beyond me. I felt bad the kid had to experience that, but at the same time, she's probably better off not being subjected to her mother's ways. The funniest part was the cashier gave the kid a sucker right before the police swooped down on them.
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Hilerious! No wait, is that the word I am looking for? No, I meant to say awful. Maybe you had to be there to see what was funny about this.
 
I don't see the moral dilemma about selling syringes to drug uses. It's harm reduction and it's one of the roles of a health care professional. Drug uses should have access to clean needles.
 
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not everyone trying to buy needles are using them for narcotics...i have friends who are police officers who use anabolics...not that i necessarily agree with them, but some feel they need that extra edge in order to protect themselves from some of the lunatics out there. they're the ones out there risking their lives to protect the rest of us from murderers, gangsters, and rapists...if that's what it takes to give them the confidence or stamina to protect the rest of us....then so be it....
 
FormerRT said:
not everyone trying to buy needles are using them for narcotics...i have friends who are police officers who use anabolics...not that i necessarily agree with them, but some feel they need that extra edge in order to protect themselves from some of the lunatics out there. they're the ones out there risking their lives to protect the rest of us from murderers, gangsters, and rapists...if that's what it takes to give them the confidence or stamina to protect the rest of us....then so be it....
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I am sorry but this is one of the most ridiculous things I have heard in a while. Our military is out there dealing with much worse and they don't take steroids.
 
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NaOH said:
Drug users should stop being drug users.
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One of the harms of street drugs are the negative health effects associated with needles. If you can reduce those, you are improving the quality of life of disadvantaged and addicted people. It is not our place to deny services based on personal moral judgments. The fact of the matter is that they will be in better health and everyone in society is better off because of that.
 
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rxlea said:
I am sorry but this is one of the most ridiculous things I have heard in a while. Our military is out there dealing with much worse and they don't take steroids.
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ummmm....actually....there are military who use anabolics as well....like i said, i don't necessarily agree with it, but i also choose not to judge those who do it....i wouldn't be willing to put myself in lethal positions that put me in immediate danger....however they choose to justify it to themselves, in my opinion it is their decision...the only point i'm trying to make, is that not everyone seeking needles and syringes are junkies....
 
FormerRT said:
ummmm....actually....there are military who use anabolics as well....like i said, i don't necessarily agree with it, but i also choose not to judge those who do it....i wouldn't be willing to put myself in lethal positions that put me in immediate danger....however they choose to justify it to themselves, in my opinion it is their decision...the only point i'm trying to make, is that not everyone seeking needles and syringes are junkies....
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Really??! I had no idea. Don't they drug test our police officers/military? Regardless, police officers are supposed to be upholding the law/protecting citizens. Junkies or not, using steroids on the job is a bad idea.
 
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FormerRT said:
ummmm....actually....there are military who use anabolics as well....like i said, i don't necessarily agree with it, but i also choose not to judge those who do it....i wouldn't be willing to put myself in lethal positions that put me in immediate danger....however they choose to justify it to themselves, in my opinion it is their decision...the only point i'm trying to make, is that not everyone seeking needles and syringes are junkies....
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rxlea said:
Really??! I had no idea. Don't they drug test our police officers/military? Regardless, police officers are supposed to be upholding the law/protecting citizens. Junkies or not, using steroids on the job is a bad idea.
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Most military are drug tested pretty often. Also most are in pretty frequent contact with various people in the medical field who will see the signs of usage and put a stop to it...
 
rxlea said:
Really??! I had no idea. Don't they drug test our police officers/military? Regardless, police officers are supposed to be upholding the law/protecting citizens. Junkies or not, using steroids on the job is a bad idea.
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If buying steroids funds organized crime, then its bad.

But simply using steroids is a personal decision. Even though it's illegal on paper, it's really nobody's business but the officer in question. They are adults and should know the health risks and hopefully they can use it in an informed manner.

A pharmacist is ethically obliged, if they know that their patient is on steroids, to help that person prevent negative health outcomes. Even though it is immoral to that pharmacist.

(If pharmacists would refuse to see you after knowing you did drugs/steroids, then that would force the patient to conceal that fact and even this alone could lead to drug interactions and other negative outcomes.)
 
owlegrad said:
Hilerious! No wait, is that the word I am looking for? No, I meant to say awful. Maybe you had to be there to see what was funny about this.
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Well, i didn't mean the situation itself was funny. In fact I was pretty overridden with guilt about the kid afterwards. You're kind of right, in that "you had to be there." If you knew the cashier I work with, it would make more sense. She's an older lady with a really thick Texas accent and suffers from Parkinson's. What I meant that I thought was funny was that as nervous as she was (her shakes were really bad and she was stumbling over her words because she knew what was about to happen), that she was clear headed enough for that one second to offer a sucker to the kid. I guess it was her way to bring the situation back to normalcy or something.
 
loo said:
Law of co-pays:

1. The more well-off and insured you are, the more likely you will bitch about your copay.

2. The more you complain about me "charging" you too much, the less you have read your insurance contract.

3. It is never the patient's responsibility to know their coverage...
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Just because you have medical does not mean you get EVERYTHING for free.
 
If your coupon for Cialis does not go through because you did not properly activate it, please don't yell obscenities at the pharmacy staff and try to start fight with customers who are only trying to calm you down.
 
rxlea said:
Really??! I had no idea. Don't they drug test our police officers/military? Regardless, police officers are supposed to be upholding the law/protecting citizens. Junkies or not, using steroids on the job is a bad idea.
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hahaha!! i don't know how army is, if they were different but from what i was told, AF typically tests for narcs only, anabolics testing is different, they can run the extra tests, but not always, most of the times its done if your chain of command specifically asks for it, if they have someone specifically they are suspecting, or if a unit seems to be more prone to abusing it. that's prolly how people slip through the cracks, same with police officers.
 
FormerRT said:
hahaha!! i don't know how army is, if they were different but from what i was told, AF typically tests for narcs only, anabolics testing is different, they can run the extra tests, but not always, most of the times its done if your chain of command specifically asks for it, if they have someone specifically they are suspecting, or if a unit seems to be more prone to abusing it. that's prolly how people slip through the cracks, same with police officers.
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Varies in the Army, but normally there's at least one (somewhat) random drug that is added to what is tested for. Chain asks for tests but not specifics...

Good medical personnel are going to put a stop to most steroid use before drug tests though.
 
Aren't anabolic steroids legal if you have a prescription? Personally, I'd prefer it if the US Military had all of its soldiers on some form of human performance enhancement. Drugs to feel less pain, fight longer, and to shut off the emotional component of the brain. Don't need to be just the most technologically advanced army, have the physically strongest army too.
 
Sparda29 said:
Aren't anabolic steroids legal if you have a prescription? Personally, I'd prefer it if the US Military had all of its soldiers on some form of human performance enhancement. Drugs to feel less pain, fight longer, and to shut off the emotional component of the brain. Don't need to be just the most technologically advanced army, have the physically strongest army too.
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Yes, you can get prescriptions for some... A lot of probs come with most usage though...
 
Sparda29 said:
I love that Costco doesn't accept Medicaid as a payment.
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Sometimes, I wish we didn't, but looking at our reimbursement rates, it's almost necessary. Medicaid is our highest reimbursing PBM in Louisiana. We actually lose money on a lot of scripts we fill through commercial insurance (Catalyst, Caremark, Express Scripts, and Humana are notorious for this), but I can think of one patient where we've made over $1000 gross profit from 1 refill of ondansetron with Medicaid as her secondary. How's that for efficient use of tax dollars :confused: Works out well for the owner of my pharmacy though. Granted that claim was right after the price of the medication dropped from like $15 a pill to less than a dollar/pill, but even more recently, we still make several hundred dollars per fill on it. LA Medicaid takes forever to update their system with new pricing and when new generics become available.

Out of curiosity, does Medicaid in anyone else's state only cover brand name on certain medications? Here are a few generics they won't cover here, but they will cover the equivalent brands: mixed amphetamine salts/Adderall XR, ofloxacin/Floxin, fluticasone/Flonase, malathion/Ovide, and previously sertraline/Zoloft (they have since started covering sertraline). I actually called them to ask why because I couldn't understand the blatant misuse of money, and the answer I got is that the state gets a rebate from those brand name manufacturers. Maybe for something like Adderall, I can understand, but the price margin between brand and generic for something like Zoloft or Flonase is so wide that it's hard to believe they come out ahead even with a rebate. Probably crooked LA politics at play, I'm sure. It IS what we're known for after all.
 
Sparda29 said:
Aren't anabolic steroids legal if you have a prescription? Personally, I'd prefer it if the US Military had all of its soldiers on some form of human performance enhancement. Drugs to feel less pain: Heroin, fight longer: Amphetamines, and to shut off the emotional component of the brain: oh I dunno, how about a Seroquel, Geodon, & Lithium cocktail?. Don't need to be just the most technologically advanced army, have the physically strongest army too.
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Either that or you're suggesting that we have Skynet take over military recruitment which would give us both the strongest and most technologically advanced army ;).

Keep in mind that soldiers are still human beings now. I'm sure they don't want to become mindless zombies.
 
b1234 said:
Varies in the Army, but normally there's at least one (somewhat) random drug that is added to what is tested for. Chain asks for tests but not specifics...

Good medical personnel are going to put a stop to most steroid use before drug tests though.
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I doubt they test for steroids during routine/random drug tests. Most likely your standards, BZDs, Opiates, Amphetamines, etc. If they were athletes then maybe steroids, otherwise unlikely.

Not sure why people are okay with illegal drug use regardless of the population being referred to.
As for needle exchange, if it's legal, fine, otherwise, regardless of the background excuse, why does one illegal act deserve another?
 
By3Times1Minus1 said:
Out of curiosity, does Medicaid in anyone else's state only cover brand name on certain medications?
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Yes! In MN they do not cover d-amphetamine salt combo or lansoprazole. They do cover the rest of the generics you listed though. I've always been irritated by that... especially since Prevacid is so expensive.
 
I'm offended, I'm on Lithium, Seroquel, and Geodon and I definitely still have emotions.
 
rxlove said:
Yes! In MN they do not cover d-amphetamine salt combo or lansoprazole. They do cover the rest of the generics you listed though. I've always been irritated by that... especially since Prevacid is so expensive.
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Ah, I forgot about Prevacid. They don't cover lansoprazole in LA either. Funny thing is they did cover generic Adderall XR for a short period here several months after it came out, then they quit covering it again.

qualquun said:
I'm offended, I'm on Lithium, Seroquel, and Geodon and I definitely still have emotions.
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No you don't. That's just what the drugs want you to think. I kid, I kid. Sorry to offend.
 
Lol, this is a hilarious thread!

I had an interesting call with a tech about a decade ago

Me: Hi! This is (first name) (last name). I'm calling to refill my (medication name)
Tech: Can you spell your last name for me?
Me: Ok. B-
Tech: V?
Me: No, B as in boy
Tech: V as in voy?
Me: No, B as in barometer
Tech: G as in garometer?
Me: NO! B as in bathrobe!
Tech: C as in cathrobe?
Me: NO! B! B! Second letter of the alphabet! B!
Tech: Oh. Why didn't you just say 'B as in brown'?
D'oh!

In retrospect, I think free-associating with phonemes was just her way of messing with me. I never called again.
 
aza said:
Lol, this is a hilarious thread!

I had an interesting call with a tech about a decade ago

Me: Hi! This is (first name) (last name). I'm calling to refill my (medication name)
Tech: Can you spell your last name for me?
Me: Ok. B-
Tech: V?
Me: No, B as in boy
Tech: V as in voy?
Me: No, B as in barometer
Tech: G as in garometer?
Me: NO! B as in bathrobe!
Tech: C as in cathrobe?
Me: NO! B! B! Second letter of the alphabet! B!
Tech: Oh. Why didn't you just say 'B as in brown'?
D'oh!

In retrospect, I think free-associating with phonemes was just her way of messing with me. I never called again.
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You could have played along :laugh:

Maybe she saw you in the pharmacy one time and was trying to mess with you.
 
Here is one that’s a little more... do I dare say normal.
A friend, who had a headache was running late, grabbed the first thing resembling aspirin and took off. Shortly after arriving at work he was not quite with it, feeling the full effects of the 2mg xanax, and was sent home. It happens, it could have been worse.
Keep em in the original bottles and maybe take a quick glance of what you’re about to pop, does it look right to you?
 
$40??? I'm not paying for that.
$20?? I'm not paying for that.
$10?? Ok I'll pay.
 
The other day at work this lady was adamant about getting her Viagra rx filled for her husband who was with her at the time. She said that it was their anniversary and she was going to lay it down on him and needed him to keep up. She had some HTN meds that she was filling at the time and some vytorin I think. She didn't have enough money to get all the meds so she told the pharmacist to just fill the viagra instead. She came back the next day for the other meds.:laugh:
 
DrFrankenstein said:
Here is one that’s a little more... do I dare say normal.
A friend, who had a headache was running late, grabbed the first thing resembling aspirin and took off. Shortly after arriving at work he was not quite with it, feeling the full effects of the 2mg xanax, and was sent home. It happens, it could have been worse.
Keep em in the original bottles and maybe take a quick glance of what you’re about to pop, does it look right to you?
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Hmmm... They make xanax 2mg that looks like aspirin? Back when I worked retail, they were the bars and we don't dispense them at the hospital. It is just interesting that someone would take a xanax instead of an aspirin since the xanax (you hope) would be in an Rx bottle! Silly patients... !!!
 
delano2000 said:
The other day at work this lady was adamant about getting her Viagra rx filled for her husband who was with her at the time. She said that it was their anniversary and she was going to lay it down on him and needed him to keep up. She had some HTN meds that she was filling at the time and some vytorin I think. She didn't have enough money to get all the meds so she told the pharmacist to just fill the viagra instead. She came back the next day for the other meds.:laugh:
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lmfao! Hey, maybe that took care of her HTN problem for a day :)
 
rxlea said:
Hmmm... They make xanax 2mg that looks like aspirin? Back when I worked retail, they were the bars and we don't dispense them at the hospital. It is just interesting that someone would take a xanax instead of an aspirin since the xanax (you hope) would be in an Rx bottle! Silly patients... !!!
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We had someone complain to the high heavens when she picked up her Xanax prescription. We gave her Alprazolam since she was uninsured and the Dr. hadn't written DAW on the Rx. I was brand new to pharmacy, so I was dumbstruck when she kept insisting "these aren't the bars, man. I'm supposed to get the bars." :confused:
 
pharm B said:
We had someone complain to the high heavens when she picked up her Xanax prescription. We gave her Alprazolam since she was uninsured and the Dr. hadn't written DAW on the Rx. I was brand new to pharmacy, so I was dumbstruck when she kept insisting "these aren't the bars, man. I'm supposed to get the bars." :confused:
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:rofl: you know why they want the bars, don't you? They can sell them piece by piece. I've seen it happen.
 
Both Alprazolam 2mg and Xanax 2mg come in bars... that's why... prob got 1mg and got pissed :D

And Delano... she got PAAAAAIIIIIDDDDD!!! for being a good wife :D
 
pharm B said:
Yeah, after she stormed out without her bars, I was told why she wanted them. I learned about "purple drank" the same way.
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PURPLE DRANK.......hahahahahaha......good ol' phenergan w/ codeine....this is what i'm calling it from now on by the way.....hahahaha :laugh:
 
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