F*cking Cold

So, as you may or may not have noticed, its f*cking cold out. (I don't know why I used the * in place of the u because I normally use the f word like a hooker uses crack on this blog).

I just got in from a walk in the blustery weather that has graced our fair capital city as of late. It is -23 degrees (Celsius for you American folk) but feels like -33 with the wind chill. I don't know how they figure out what it 'feels like' although I'm sure there's a completely logical explanation. However, I don't care. I imagine it goes something like this.

Scientist #1: How cold is it out there?
Scientist #2: I dunno, its fucking cold, probably about -33 degrees.
Scientist #1: Eureka!

And they do it with snotty British accents and instead of saying 'minus thirty three' they would say 'negative thirty three'. You know how they are.

So anyway, I just about froze my face off. However I'm not as bitter about winter yet as I was last year around this time. I think its because I'm living downtown and seeing all the big ol' trees that look all pretty in the winter time. Small things like that get me through.

Moral of the story... if you want to just about die because you've underdressed like a moron but yet still feel the need to walk far enough way from your house that you know you might not make it back alive yet still want to be amazed at the beauty that is winter, then walk through Regina. We have it all!

Seniors Drug Plan Sucks

"Under the Seniors' Drug Plan, all Saskatchewan residents 65 years of age and older are eligible. Seniors will be automatically covered based on Health Registration Card information; no application is required. The program will go into effect on July 1, 2007.
Low-income seniors receiving the Guaranteed Income Supplement, Saskatchewan Income Plan or Special Support coverage who currently pay less than $15 per prescription will continue to do so. Palliative care patients and those covered by Saskatchewan Aids to Independent Living (SAIL) will continue to receive Saskatchewan Formulary drugs at no cost."

-from the Government of Saskatchewan website http://www.gov.sk.ca/budget0708/drugplan

The Saskatchewan Prescription Drug Plan will cost Saskatchewan taxpayers $262,485,000 this year, up from $201,936,000 last year (from:http://www.gov.sk.ca/adx/aspx/adxGetMedia.aspx?DocID=799,1,Documents&MediaID=973&Filename=07-08-Finance-BudgetEstimates-En.pdf). Although I couldn't find a breakdown of how much this $15 plan will cost the taxpayers, as a pharmacist, let me tell you thats it a lot.

Now, I don't have a problem with paying for necessary medications, in fact I'm all for ensuring that people have quick and affordable access to necessary drugs. So whats my problem with this new drug plan aimed at those over 65? They already had a system set up for lower income families who needed the subsidy. No one in Saskatchewan should want for medications... there has been a formula for years that compares how much you make to your drug expenditures and ensures that you get access to those medications. So if these seniors actually needed a medication to live but couldn't afford it, the government paid for it already. This new drug plan isn't really helping anyone and its costing us millions of dollars that could go to other causes, such as helping those with mental illness, community healthcare and education about preventing disease.

Many seniors have a large bank account to begin with, they don't need the government's help to pay for their Lipitor or Pariet. Of course they appreciate it, which shows that this is simply a vote buying tactic. Schizophrenic people don't vote in numbers like the penny pinching seniors, now do they, so why would we spend money on them?

As far as the launch of this program goes, the government effed it up too. Watching ads on this plan and reading articles, one would expect that if you're over 65 all you will have to pay is 15 bucks for anything. Most people don't understand what the formulary is or care to learn about it. So they get pissed when certain medications, Viagra, for instance, aren't covered by this new plan. They get pissed that they have to pay $15 for each medication, not just their total for the month, and they don't understand why the pharmacist is ripping them off.

Yes, we, the pharmacists who are helping you get your medications are ripping you off. Maybe the government should have explained that the formulary is a list of drugs that they will pay for. Drugs that are not listed in the formulary will not be covered. There is a seperate list called EDS drugs for which you need to be approved by Sask Health before you can receive these medications for $15. Where was that in the ads? Common medicines for the elderly such as alendronate, the PPI's, etc are generally listed as EDS drugs. Why were the public not informed of all the intricacies of the plan before it was rolled out? Why did the government not back up the pharmacists who were out there administering this plan? We're stuck looking like the bad guys, as if we're in charge of what they have to pay.

Also, people are now using more medications. Instead of trying cheaper alternatives, now they're all the same price, so lets take them all! Instead of preventing heart disease through lifestyle management, now you can treat it for the low low price of $15 per month! More money for another Big Mac, eh?

In summary, I think this is a stupid way to spend money. This program doesn't benefit the people who need it the most, it only benefits those who will vote NDP. I hope they scrap it soon, because right now we're cashing tomorrow's cheque to pay for the past. Stupid.

Tales From the Pharmacy

I've been doing a lot of relief work at different pharmacies lately and have come across quite a variety of people. This latest tale takes place in a very busy community pharmacy where the third year student was busting her ass trying to keep up with the mound of Rx's waiting to be done.

The phone rings, its a jack ass doctor calling in a prescription for one of his jack ass patients. (Actually it turns out she was a sweetheart of a patient, but the doctor, still a jack ass). The student answers the phone and states that she is a student, and assures the doc that she can take the Rx over the phone. When he tells her to just 'renew them all for a year' she asks which ones. He rambles off some list spoken in broken English with a thick accent and probably with his mouth full of Big Mac... cause thats how these doc's roll. We can tell that she's flustered by this crappy method of renewals but hangs up the phone and frantically goes through the profile trying to find out which ones he meant.

The other pharmacists and I hate this kinda shit... and decide that if he wants to renew his Rx's he can sign a piece of paper and fax it to us. We print off the entire profile and ask him to do exactly that... it turns out to be 7 pages long. Within minutes the phone rings again and I answer to a very irate doctor saying that he's exhausted with dealing with people who don't know what they're doing and he's irritated with having to do so much work. He states that our student was not vigilant enough and that she must improve her vigilance if she plans on getting ahead. I reply that his list was quite long and that we prefer to have them state each medication and directions before hanging up, you know, for patient safety's sake. Thats why we faxed it over, so we could be sure thats what he meant.

He said that the patient brought in a list and he just ok'd them, and that he wasn't sure what the list was anymore cause she took the list back. I then asked him to tell me again what meds he wanted her on to which he replied "How the hell am I supposed to know what she should be on?" and hung up. So much for vigilance.

In Response to "Rambling Dave"

I figured it was time for an update despite my impending exam this afternoon. Rambling Dave apparently commented on my last post and I figured this would be a good topic for a post. I copied and pasted it here for your reading convenience:

Rambling Dave said...
Mike,I was refered to your blog by a listener.Three thoughts for you (although, I am an ass clown so it seems unlikely that you will give them much consideration)... (1) I am not anonynous when I sling it.(2) There is an off button. (3) You will have more impact with less vitriol. Radio is a funny business. It's free to the user. But, I think that because it's music which tends to be very personal people get really worked up about it. If we are not to your taste, don't listen. One of the problems in a community the size of ours is that there are not enough radio stations to serve everyone's taste.Regards,Rambling Davewww.C95.comDave@C95.com
5:58 AM


And here is my response:

Rambling Dave, although I think you are an ass clown I will give your comment due consideration as I'm always considerate of my readers, yes, all five of them. Anyway, I find your comment to be a little lacking in thought. First, I'm not anonymous and if need be I could 'sling' this publicly, I really think you are that unfunny. Although there is an 'off button' if you read earlier up in my post you would see that I don't have other listening options and as much as I hate to say it, you may be the lesser of the evils. No wait, thats not true, I just like to bitch. As for your third point I am not here to make an impact. I don't want you to lose your job or make some broad changes to Saskatoon's radio scene, this was just a rant on my little blog.

As for the limited options in such a small community, as you put it, I would point you to the radio stations in Regina which offer quite a diverse range of listening options. From the tragically unhumorous CC, Lori and Buzz to the antics of The Wolf and all the way down to the country spectrum, Regina offers many different types of shows and playlists. Further, according to the latest census Regina actually has FEWER people than Saskatoon! How could they have more radio stations if your argument is to hold water?

Clearly the only answer is that Saskatoon radio sucks. I don't enjoy your show and I don't think many people do, maybe you can do a Rambling Dave poll on that one. Either way, this was just a little rant on my little ol' blog, no need to get your panties in a knot.

Regards,

Mike

Saskatoon Radio Sucks!

As if I didn't have enough reasons to want to leave Saskatoon, here's one more... radio. I'm a fan of music. Unfortunately I'm cursed with not having a compact disc player in my vehicle, or satellite radio. I do have an iPod radio thing, but thats a pain in the ass to set up for daily commutes. So I have no choice but to listen to the radio. The radio that is pumped into my car 24 hours a day, seven days a week for FREE! Well you get what you pay for.

But lets cut to the chase. Saskatoon radio is airwave vomit. If they held a competition to find the most annoying and socially retarded people in the country, they'd find Rob, Shawna and Ramblin' Dave. What kind of radio name is "Ramblin' Dave"? Might as well have picked 'Babblin' Bill' or 'Retard Russ'. Anyway, its not enough that I have to listen to the shitty light rock and teenage girl pop on my morning commute every day but those damned ass clowns keep interrupting my few moments of peace during KC's 'Since U Been Gone'. I don't fuckin' care how many pairs of shoes Shawna Foster or indeed, the entire city of Saskatoon has in their closet. I know Shawna's a douchebag regardless of the fact that she owns 50 pair. And Ramblin' Dave.. fyi... you don't know it all and if you want to end each 'Random Ramble' with a 'tip' make sure its a real fuckin tip. Advice usually ends with you suggesting something, not just crapping out of your disgusting mouth.

Ramblin' Dave definitely has a 'face for radio'

And onto Rock 102. I'm sorry, but you need to play rock music to qualify to be a rock station. That means no Avril Lavigne. She has her place, now learn yours. Also, who the hell named someone Gregger? or Gregor or whatever? Call yourself Greg because you effin' irritate me. Further, where is this 'Cast of Thousands' that you claim to have each and every morning? I'd like to hear what they have to say instead of your tired old stories day after friggin day. I almost feel that calling them radio 'personalities' is a fib.... and I'm no fibber.

The diarrhea icing on the shit cake that is Saskatoon's airwaves is 'Coffee Talk with Vic Dubois' Who is this guy and why is he being played every morning (and afternoon, as I found out today) with his monotone voice and lack of anything interesting to say? Everytime I hear his voice I want to honk my horn to drown him out, or swerve into oncoming traffic. No, actually, I'd rather hear Beyonce's 'Irreplacable' sung as a duet with Fran Drescher and Gilbert Gottfried... and just the super annoying 'to the left' part all the way from my house to work than hear another one of those GD Coffee Talks.

"To the left, to the left... To the left, to the left.. To the left, to the left... To the left, to the left.. To the left, to the left.."

Oh, I forgot those Saskatoon Job Shop commercials. Your joke about the irritated boss eating donuts was mildly amusing the first time you played it. Weird how the four hundred times you play it each day doesn't add to that amusing quality. I'd rather be unemployed than search for a job with you. Go to hell.

So, as you can see, Saskatoon radio is balls. I'm excited to listen to some Chris and Ballsy in Regina... those guys are a good time. Funny how Regina can have such kick ass radio, but Saskatoon can't manage to muster up one decent 'personality'.

Anyway, I'm spent. I'm Mike, I know it all and this has been 'I hate Saskatoon Radio' rant.

My Feelings Toward Winter

I'm getting sick of this cold, miserable weather. Quit toying with me, Mother Nature, or I'm not going to feel so guilty the next time I leave the lights on, the car running, use old fashioned CFC spray cans, burn tires. Just kidding, global warming is bad, but so is being cold.

I'm Not a Doctor, But I'm Still Smarter Than You

"Yet another post on how its so tough to be a pharmacist!" you're probably thinking. Well cram it up your stink hole, cause the rant is coming whether you like it or not.

Working at St. Paul's puts me in direct contact with the unwashed, hospitalized masses. Although I generally love what I'm doing - hot, steamy, pharmacist on patient action - because its what I've been trained to do there are a few, nagging details that they don't teach us in pharmacy school.

1. They never taught me how to talk loud enough to cover my patient's roomates poop noises coming out of her less than strategically placed commode.

2. They never taught me how to cover my nose with a necktie to cover the associated smell.

But I digress.

They also don't teach us how to take rejection from the uneducated population. Yes, I know I've spent five years in school learning, in depth, how to medicate you and resolve your drug related problems, but how dare I suggest that your family physician that you see once every six months for perhaps five minutes each visit may have been incorrect about something? Or even that the guidelines for treating diabetes have changed since 1973 (SURPRISE! You don't HAVE to go blind).

Let me fill you in, I know you crave to see how my mind works. I have this patient, lets call her Granny, cause she's a grandma and kind of reminds me of mine (although I never called either of my grandmothers granny). Anyway, she's in for her umpteenth heart attack, her kidney function is lower than a worms belly button and she's got maple syrup running through her veins. Ever the diligent pharmacy student, untempered by experience and naive to the world, I head to my trusty guidelines and develop the best damned care plan in the enitre world for her. New insulins and injections, tapered dosing and increased glucose monitoring. Damned if I'm this woman won't live to be two hundred, the way I've souped her up. After using my many counselling techniques to 'establish a relationship' or 'covenant' if you will, we share a tear about her life and family and I feel that change has been made. I order test after test to establish baseline functions and have every professional consulted to intervene on her behalf.

But, alas, its all for nothing. None of my lab values are requested like I asked, and it appears her doctor exists only in our imagninations. On day four of our time together I consult her with my plan before I leave for my four day weekend. She tells me that she doesn't feel comfortable making changes 'on her own, without her doctor's advice'. I'm dumbstruck! Was it not that very physician's recomendations that put her here in the first place? His lack of initiative to manager her case? And damned if she's doing this 'on her own'. I spent hours researching how to get her fat ass into the next decade alive. In the end I just about pinched a tear as I turned on my heel, past her ever pooping roomate, and returned to my hobbit-hole like office in the pharmacy.

In the end I made those recomendations to the attending, just to spite that old shrew. However, in the efficiency that is Canadian healthcare she was discharged on 'prescription', which of course lets all other healthcare professionals understand the complexity of her conditon. Bah, I'm too young to be this cynical.

This is an artists rendition of me after not having my recomendations even be read.

WORD, On the Street

Anybody who knows me knows that the one thing that brings me joy, aside from my button collection, is my support and involvement with inner city youth. Some youth in our fair city do not grow up with as much privilege as others, and its good to give them a voice.

At the cafeteria the other day we came upon Word on the Street - "A Free Journal for Youth and Urban Saskatoon". At first I thought to myself 'awesome, some kick ass literature for my lunch break!' This first thought quickly turned to dismay, and then hysteria as I read through "Being Jacked" by M.P. Now I'll copy an excerpt for my readers... nah, fuck it, I'll write out the whole damned thing:

Being jacked for personal belongings is a big problem in Saskatoon.

Hats are the most common thing being jacked, which is unfortunate because some hats can cost $50 +. If you have to buy a new hat every time someone runs off with it, you're going to be blowing all your money on hats. What really bugs me is people who don't have the guts to come up to me and tell me to give them my stuff, instead they grab the hat and run as fast as they can.


- Okay, so I'm not writing out the whole thing, but you get a hint. Seriously, though, I do believe in youth in the inner city getting opportunities, but this magazine is ridiculous. Half of the titles aren't checked for spelling (e.g. Rap Music and it's Affects on Me). My favorite is the "STreet Speak" feature in which youth are asked what job they would want, if they could do anything in the world. "a male teenager" responds "I'd work on the oil rigs" And thats why our youth are so successful, with that ambition and lust in their eyes.

So yes, I'm an asshole for poking fun at an honest attempt by our youth to make themselves feel successful but honestly, forcing success on a group doesn't necessarily make results happen. Let's not overinflate these kids egoes.

And, to seal the deal... these kids are paid to write these gems. Ta-Dah! What a use for taxpayer money

Mutherfuckin' Potholes

I was driving home from work today and realized that as much as I love spring, I hate seeing what the snow leaves behind. Dirt, gravel, candy wrappers and chip bags... and since I'm the west side, syringes seem to be common. My favorite, however, is the potholes.

So not only do I have to dodge the 'riff raff' ambling across 20th street on my journey home, but I have to swerve at the last moment to prevent my axle from busting in half. I see that the city has gone out and patched a few, here and there, but those are already coming undone. (Note: Egbert and 109th St.)

I stopped and took a picture this morning during my commute.

Honestly, I know that doesn't look like Saskatoon, but remember, its the west side.

Anyway, I really hope they clean up this place soon. We wouldn't want Nelly Furtado to get stuck in Saskatoon making this city all promiscuous.

"I don't like taking pills"

This might be my all time, most hated quote from patients. Especially when I was working at the cancer centre. These people are being pumped full of poison that is pushing them towards an inch of their lives - naturally you will feel like shit for a few days. When I offer you some way of preventing the nausea, vomiting, diarrhea and heartburn that will surely ensue, don't tell me that you 'dont like taking pills'.

Case #1 - A patient comes in for her third round of chemo and I go in to drop off her steroids to prevent her from becoming a human fountain a few days later. I then ask her how her last round went. She says that she did, in fact, become a human fountain and could hardly get out of bed. I asked her how she took her meds (a pharmacist trick to see if they listened to us time without being condescending). She replied, oh, I didn't take them, I figured I was on enough medication and didn't need to pop pills. She went on about how sick she was. If the cancer wasn't going to kill her, I would have. Anyways, I told her that if she wanted to feel better, she needs to take her meds that I'm giving her. Moron.

Case #2 - A patient came in for another round of chemo and ended up puking all over the floor before the drugs even went into her. This sometimes happens when people associate a certain setting with past nauseating experiences, which is why we gave her gravol, dexamethasone and ondansetron before she came in. She failed to take them of course, because she "didn't like taking pills". Argh.

Case #3 - This one is from community experience, and isn't so much a case as it is a collective observation. If you don't take your blood pressure/antibiotic/antidepressant pills you most likely won't get better. I know you sometimes can't feel the effects of too little blood pressure/antibiotic/antidepressant drugs in your body, but it does affect how you feel. Take your damn pills.

That pretty much sums up my rant for today. I figured since I'm staying home from work due to the flu I should do something pharmacy related... such as bitching. Cheers!