The State of Education in WV

My grandmother taught in Berkeley County, West Virginia for over 40 years - starting in a one room school. My mother taught in Berkeley County for 33 years. The state of the education system in Berkeley County is quickly crumbling. South Middle Schoool, where my mother taught for 33 years, currently has nine vacancies for teachers. The high school that I attended currently has no foreign language teachers. Where have all the teachers gone? They have gone to Loudon County, Virginia to teach. In Loudon County, they are being paid twice as much. When is WV going to wake up and realize that their treatment of public educators is the pits? The victims of these policies are our children. How can children learn in an environment laced with substitute teachers? Children require a sense of normalcy and familiar faces. I remember when I was in elementary school the worst days were those when a substitute was teaching instead of my regular teacher. How can an high school operate without a foreign language department??? Foreign language credits are required not only for high school graduation, but also for college entrance! Several of the educators in Berkeley County have reached retirement age. With poor pay, lack of Board of Education support, and the inability to control the students, once retirement age is reached, these teachers are running from the public education system. They are being replaced by inexperienced, fresh out of college teachers. As with any profession, book smarts are only a piece of the puzzle with education. Experience teaches you how to handle problem children and how to address students in general. I am worried about the quality of education being provided to my nieces and nephews. Our children really are our future. If we're not educating them, where will they be in 15 years?

Teenage DXM Heads

The pharmacy where I work is forced to keep several products behind the pharmacy counter do to the high theft of these products. Some of these products include Coricidin HBP and Delsym cough syrup. You may be wondering why we need to keep a cough and cold medication for patients with high blood pressure behind the counter. The answer is one word - dextromethorphan. Thanks to the internet, teenagers (or anyone for that matter) can log on and find out how to get high from drinking cough syrup or popping cold pills. These products are not cheap. One package of Coricidin HBP contains about 6 pills and costs about $6. One 4 ounce bottle of Delsym costs $12.98. As with all illicit drugs, the costs of these products directly result in their high theft. Every day I work in my field, I become more and more aware that being a professional isn't just book smarts - it's also an ability to read people. When an individual comes to the counter with an Oxycontin prescription, most of the time I can tell if the prescription is truly legit. I can tell by their body language, their aggressiveness, their desire for brand name medications, and sometimes just by the physician that writes the script. The same holds true for these cough and cold products. When a 16-year-old saunters up to my counter and asks for the Coricidin HBP, that usually sets off my internal alarm. Granted there may be some 16 year olds with high blood pressure and there may be some that are purchasing the product for a family member; but trust me, on the whole they aren't legitimate customers. When my internal radar alerts me that the situation isn't kosher, I have found the quickest and easiest way to deal with these kids is to ask for an ID. I then take their ID and copy their name, address, and date of birth in our narcotic and poison ledger. Nothing says "oh shit" like a narcotic and poison ledger. I also write down what they purchased and the date purchased. It is my personal experience that all drug addicts hate having their personal information recorded.

Last week, an 18 year old individual from the state of Maryland showed up at our pharmacy window to purchase, you guessed it, Delsym cough syrup. I took his ID - which royally shocked him and then sold him the Delsym. I remember him because he complained about the cost the entire time I was at the window with him. Today he appeared at the window again asking for more Delsym. MN sold it to him before I could get his attention. He didn't look in the narcotic ledger - nor did he write anything down in it. After the boy left, I explained the situation to MN. SF, the other pharmacy student, got off work at 7. He called back to the pharmacy at 7:15 to inform us that he saw the boy in his car with a girl passing the Delsym bottle back and forth drinking. GREAT! Not only were they getting high, but they were also getting high and then driving! It's a pretty sad situation when you have to drink 120mL of cough syrup on a Friday night for a good time.

Why I Hate Corporate America

I received a letter in the mail today from Giant of Carlisle - the parent company of the pharmacy I work for. The letter informed me that my benefits were being terminated effective July 31, 2005. Today happens to be July 27, 2005. I hardly believe that 4 days notification is substantial for termination of health insurance. I scanned the letter for a telephone number to call - it was conspicuously absent. This was very upsetting. I called my boss at work for the number to Giant of Carlisle. When I called that number, I was informed I needed to know the name of the individual I was trying to reach. Well that was just great because I had no idea who the hell I needed to talk to. Next I dug through my files and found my benefit agreement with AHOLD. On the front was a telephone number. The poor gentleman that answered had to deal with my wrath - I was quite pissed about losing my health insurance, the fact that there was no phone number provided to contact someone, and finally for the sheer reason that they waited until 4 days before termination to notify me. After venting, I was pleased to find that he thought I was suffering an injustice as much as I thought. He forwarded me to his supervisor - who forwarded me to a 1-800 number. The lovely lady who answered this phone then forwarded me to one more person. Apparently this was the person I needed to speak with in the beginning (and consequently her office is at Giant head offices in Carlisle!!!). CH had left her desk early today. She is supposed to be available until 5 - at 4:50PM, she had turned on her voice mail. It must be nice to just leave your job whenever the mood hits. I'm sure my manager would greatly appreciate me walking out of the pharmacy at 8:45 instead of 9. I left her a voice mail detailing my predicament along with hints at AHOLD's violation of federal law. See, my insurance is terminated on July 31 - however I have not received paperwork to apply for COBRA. Basically, AHOLD and Giant of Carlisle, and probably the actual store I work for, really don't care about their employees. When I lost my coverage under TRICARE due to my age, I received paperwork 30 days before termination to enroll in COBRA. When I lost my coverage with the insurance at the quarry, I received notification 60 days in advance along with paperwork to fill out for COBRA coverage 30 days before termination. What does AHOLD do? Why, they give me 4 days notification of termination and no COBRA paperwork! How nice of them.

From this experience I have learned that AHOLD and Giant are no different than Wal-Mart or any other corporation. They don't care about their associates - they only care about their bottom line. While profits are nice and are required to survive, you also have to have associates to man the store. The fact that they pay their cashiers $6 and shit on their part-time employees just proves to me that this company is something I do NOT want to be part of once graduating. I was supposed to receive a raise in May for my two years of dedication to the company. They conveniently forgot. Due to the diligence of my manager, I received the pay raise two weeks ago...and received retropay all the way back to May. Giant maintained that it was sheerly an oversight. I doubted that before, and now I just know it wasn't.

Oh my God, I'm Stuart!

For lunch today, I decided to grab some Chik-Fil-A. After giving me my bag of food, I asked the drive-thru guy from some Polynesian sauce. After a slight discussion about the merits of receiving more than 1 packet of sauce, the guy told me that it had been his pleasure to serve me and smiled. I smiled back and sped away. When I relayed this message to my boss (a mistake on my part - thus opening me up to ridicule the rest of the evening!!!), his reply was, "You're that guy from MadTV. What's his name? The one that says 'Stooooooop!' STUART! You're Stuart!" At first I adamantly denied this...but as the conversation drew on, I started to see the similarities. On the whole I would consider myself an assertive woman. When I don't think something is right, I speak up and say so. I go after want I want in life....except when it comes to love. Twice in my life I have gone after what I wanted...and twice I have been burned (badly on one occassion). Thus, I have become Stuart. I quickly retreat into my shyness for safety when situations like the one above occur. Stuart...I can't believe my boss called me Stuart!!! HA!

Cement Plant

This is a picture I took of the cement plant mentioned in the following posts. It was taken from atop the cement silos.

Union Made

Being the daughter of a quarry worker, I grew up in a Union family. Honestly, I can't say that I was even aware that my dad belonged to a union until I was 20 years old. We didn't buy only "union made" products. We never went to union get togethers. My dad worked for the same cement plant for 41 years - the name of the plant changed at least three times; however the structure of the plant never changed. My dad is a lifetime member of the International Brotherhood of Boilermakers, Iron Ship Builders, Blacksmiths, Forgers, and Helpers. We affectionately refer to them as the Local D-208 - their union call number. When I turned 20, for the first time in fifty years, my dad walked off his job along with every other full time employee on that plant. They were on strike. Capital Cement, the name of the plant at that time, refused to renew their contract and wanted them to work without one. After trying to reach a compromise for months, the International suggested a strike. When my dad was out, he would go walk the picket line during his normal shift (12am-8am). Some of the guys didn't walk the line; some came and walked for a few hours. My dad would go in at midnight and walk for 8 hours. He would get a check from the union for something like $35 a week. When I asked Dad why he was walking the line when the other guys weren't, he told me that he was walking for his job and for the jobs of the younger guys out there. The entire plant ground to a halt. With 100% of their employees off the plant, management was at a loss. At first, the company refused to even try to negotiate. After a week of lost production, they finally went back to the bargaining table. The strike drug on for a couple weeks and finally a temporary contract was approved. Shortly thereafter a company named Essroc bought out Capital Cement and a new contract was accepted. My dad retired six months later.

Over the next couple days, I'm going to post a series with a union theme. For two summers, I was a member of the same union as my father. My hard hat was covered with Boilermaker stickers and I went to union meetings. Also, being from WV - the heart of the United Mine Workers - I will also post on coal miners and how the UMW saved them. My sister is anti-union. I also am aware of the negative connotation often associated with the word "union." I would like to address these impressions with my personal experiences.

Employment...with Union Support

When I applied for a job at the cement plant, my application was greeted with clinched teeth. The gentleman in charge of hiring attempted to persuade me not to work at the plant. He told me how dangerous it was and how it was no place for a lady. As a firm believer that a woman can do anything a man can, this really pissed me off. I told my father to contact the union. The next day management finally caved and hired me. It was quite obvious that they weren't happy about a young woman working at their plant. I was the only female college student who applied for work. The full-time crew had only 3 female employees - all of which had been employed for over 20 years. It was evident that my young age and gender made them quite uncomfortable. In order to work at the plant, I had to complete a physical at their preferred walk-in clinic. At this clinic, the sexual discrimination was even more evident. The physician refused to sign my form saying I was physically fit for manual labor. I stood up and told him that if he didn't sign my form, he'd be facing a sexual discrimination suit. He quickly backpedaled - but still suggested that I work in the office, because (and I quote) - "Women should work in offices and not do manual labor." After this fiasco, I was forced to perform a "lift test." In order to work at the plant, I had to be able to lift over 50 pounds. I squatted 20, then 30, then 40, and then 50 pounds. This wasn't good enough. I then had to lift 50 pounds five times. By the last repetition, I was so tired I didn't think I could do it. The physical therapist told me that if I could not lift the 50 pounds again, I would fail the test and be denied employment. Totally pissed off, I lifted the 50 pounds one last time. The physical therapist reluctantly signed the form saying I passed. On my first day of work, I was discussing this experience with my fellow co-workers. Much to my surprise, they didn't have to lift anything. Being the daughter of a fellow union member, I knew who the union representatives were. I went straight to JG and told him what happened. He was furious. The entire union backed me and was going to bring a sexual discrimination suit against the cement plant as well as the walk-in clinic that I was taken too. In order to avoid a lawsuit, the company offered me a deal. I would not file a lawsuit and in return every one of the boys that were hired would have to go back to the clinic and perform the same lift-test as I did. I agreed. I wasn't looking for a lawsuit, I just wanted equality. The union backed my decision. I truly believe that if it wouldn't have been for the union, I never would've been hired by the cement plant. Moral of the story - sexual discrimination is alive and well in the 21st century. Silently walking away from situations like mine only stokes this fire. It was refreshing to see 150 men stand behind me and say, "She can do this job." Without the union support on this issue, I probably never would've worked at the cement plant...and missed out on one my life's greatest experiences.

Strike Atmosphere

My dad's union went on strike during April of 2002. In June of that year, I applied for a job at the plant. The atmosphere on the plant was very tense. There was a group of about five guys that went to work at the plant while the union was on strike. They were affectionately referred to as "scabs." The breakroom had a line drawn on the floor. Tables to the left were for union members only...tables on the right had "scabs" written on them. All of the appliances in the break room - the coffee maker, the microwave, and even the refrigerator - were moved to the union side of the breakroom. I was often placed in a work crew with the "scabs." Personally, I treated them no different than any other worker. I was about the only person on the plant who did this. One day we left our water cooler on the roof of the mill building. We returned the following morning to discover that someone had urinated in it. The message was quite clear - these boys weren't welcome. As the daughter of a full-time employee, I wasn't treated this way. The tension on the plant did not subside until late that summer. The scabs still weren't allowed on the union side of the lunch room, but the appliances did return to their normal positions. The crude remarks stopped being etched in the table tops and the threats of violence subsided. I think this was because as time progressed, less and less of the scabs were left on the plant. Essroc only employed them for 90 days - so by mid-July they were all gone. The line was erased off the breakroom floor. All returned to normal. It may seem that the treatment of these five guys was harsh - and I have to agree that a lot of the stuff was mean. However, you have to realize that when the full-time guys were out on strike, not knowing whether they would ever have their jobs again, these five guys walked right past them with indifference and took their jobs. Those are slow healing wounds...

HIPPA Violation?

I think I may have violated the HIPAA law today. Consequently, it's 2:00AM and I'm still up thinking about what transpired and trying to decide if I really violated it or not. Here's the situation... Woman comes to the pharmacy window and tells me her husband was recently started on two anti-diabetic agents. She remembers one medication is glipizide but cannot remember the second. I pull up her husband's profile and ask if she is referring to the metformin and the glipizide. She informs me that she is and that she was a question about them. She wanted to know the side effects of each medication. I printed her an information sheet about glipizide and metformin. She then informs me that her husband has been experiencing depression and she thinks it is directly correlated to the new medications - being as it started roughly around the time the new meds were started. I glance over the sheets and see that glipizide has "mental/mood changes" listed as a possible side effect. Metformin has no such side effects listed. I consulted my trusty Drug Facts and Comparisons reference guide as well as the package insert for metformin - still no mental/mood changes listed. I inform her that the depression could be a side effect of the glipizide but that her husband should check with his doctor. This is where she drops the bomb on me - her husband has left her. He apparently, in a fit of depression, packed all his stuff and moved out of the house. He won't go to work, he won't talk to anyone, and he won't come out of the apartment. She tried contacting his doctor, but the receptionist informed her that they were "too busy" to deal with her husband's problem. Left with no where to turn, she showed up at the pharmacy. She next asked me to tell her when the refill of glipizide is due so that she can talk to her husband. At this point, warning bells were sounding and bright red lights were flashing. I turned to my boss and said, "Um...I can't tell her that." And he says, "I don't think we should." So I tell her I can't release that information and she gets upset - not mad, but very sad. She wants help for her husband. She wants me to call her husband and discuss the situation. I tell her I cannot do that - he has not approached me with a problem. Finally, I agreed to call her husband's doctor and discuss the situation. I told her that I couldn't call until tomorrow - but that someone from the pharmacy would call the doctor tomorrow. I did not release the patient's doctor's name to the wife. Finally, somewhat satisfied, she begged me one last time to help her husband and then walked way from the counter. Tomorrow (well, actually today) my boss will place a call to the patient's doctor to discuss the situation.

My gut tells me that I did the right thing. I know this patient very well. He usually is a jovial guy - always smiling at the counter and talking with the staff. He always picks up prescriptions for his wife and himself. He's just a very nice guy. It's upsetting to think of him in a situtation like this. If it is the medication causing this situation, it's very tragic. And...if he's that depressed, is he suicidal? I truly feel that this man needs help. It's really sad when a federal law prevents you from providing the best care possible for people. My duty to warn far outweighs my HIPAA responsibilities - at least to me personally.

I wonder if my APhA Professional Liability insurance policy covers HIPAA violations? Sounds like it's time for a Prilosec OTC (for stomach ulcer prevention - increased stress = increased ulcer risk) and a Benadryl (for calming and sedation and these Godforsaken hives!!!)

Breaking News!!!

The Senate and the House have been hard at work extending day-light savings time! That's right! London's been attacked by terrorists twice in two weeks, Egypt was rocked by blasts, and our Congress is extending day lights saving time! I'm glad to see we have our priorities straight. I don't know about you, but I'm going to lose sleep tonight knowing that I'm being robbed of an extra hour of sleep for a total of three weeks (1 in the fall and 2 in the spring)...stupid Congress...

Fraud in Charity

You may have noticed that the One Campaign banner that used to adorn my sidebar is conspicuously absent. Back before the Live8 Concert, I discovered the One Campaign. It is a supposed non-profit organization that was pushing for more aid for poverty at the G8 summit. Prevention of the spread of AIDS across Africa and parts of Asia is a cause that is close to my heart. I think this is because I am entering a health profession field and feel compelled to serve the public the best I can. With this in mind, the One Campaign seemed like a great organization for me to help with this cause. At first all they wanted was a signature on a petitition that was being sent to President Bush prior to the G8 summit urging him to increase aid to Africa. I also signed a letter sent to my state senators - Senator Byrd (my, and WVs, hero!) and Senator Rockefellar. I wanted to donate to the cause. Being the poor college student that I am, I was looking for a cheaper way to help. The Campaign was selling those rubber arm bands with "ONE" imprinted on it. I purchased 10, the minimum amount, for $15. I was informed that my shipment would not arrive in time for the G8 summit - which was fine with me. Then I received an email two weeks later informing me that my arm bands were back ordered due to high demand - which again was fine with me. The next day I received my credit card statement and there was a charge from the One Campaign on the card for the arm bands. Ok - this was NOT fine. Charging someone for merchandise that has never been shipped is fraud. I promptly notificed the One Campaign to remove the charge from my credit card until the bands shipped. Three days later, a "supervisor", from the Campaign emailed me to inform me that my order had been canceled and that if I still wanted to "help" I could reorder in 30 days. I figure they were never going to ship the arm bands and that they were banking I would forget about the charge on my card. What a crock! It's a shame that so-called charitable organizations have to resort to these tactics. It makes me leary of ever donating again...

Pass the Benadryl

Last week, I decided to change laundry detergent AND fabric softener. This week, I've been battling a rash. In my old age, I have apparently developed sensitive skin. Great. I kept telling myself that the rash was getting better; however today I could lie to myself no longer. I got out of the shower and promptly noticed pancake-sized splotches everywhere from my chest to my feet. The were located on my abdomen and my back; my thighs and my knees; and even on my face. I finally gave in and called my doctor's office. You know its never a good sign when the receptionist is describing your symptoms and the doctor says, "I want to see her now!" So 45 minutes later, I was sitting on the examination table at the doctor's office. We went through a barrage of questions first to see if one of my patients had infected me. Since I was on vacation last week when the rash first appeared, we pretty much ruled that out. (He kept making sure that I hadn't been near Washington Hospital Center in a long time...HA!) After he deduced that I probably wasn't contagious, he decided to actually sit beside me. He was quite perplexed by the rash. Basically it consists of random patches of red circles about 4-5 inches in diameter with a yellow center. These patches are very warm to the touch. The largest one encompassed my entire lower back and the smallest was a fifty-cent-piece-sized welt just below my belly button. My doctor is pretty sure that I have contact dermatitis from the new laundry detergent. I have been placed on Allegra - of which I was to take 1 pill twice today and then 1 pill once daily for the next week. I also was instructed to use Aveeno fragrance free, dye free soap and Eucerin lotion after showering. He also suggested fragrance free laundry detergent - but I'm not ready to take that leap yet. I like the scent that Snuggle leaves on my clothes dammit! If Cindy Crawford can make a mole sexy, I surely can make a rash sexy! HA! :)

Airport Security

This evening I went with my mother to Dulles Airport to pick up a family friend. This was a harrowing experience to say the least. The last time I picked up a friend at the airport was March 2001 - six months before 9/11. My, my how things have changed. Back in March 2001, I went met my friend at the gate. Today I had to wait by the stinking baggage carousel. Beside the baggage carousel is a walk way with doors thta only open outwards. Inside these doors are two "airport security agents." I use this word very loosely because Barney Fife would protect the country better than these two morons. My friend's airplane was a little late landing, so I had the opportunity to watch these yahoos. The one guard was a middle-aged, balding man who was wearing latex gloves. The other guard was a middle-aged woman who looked really happy to be at work. These guards have two jobs. The first job is to prevent individuals in the baggage area from entering the "secure" area. The second job is to make sure that individuals walking down from the terminal ONLY walk out the doors, not back up the walk-way. Last time I checked, if you were in a secure area and never left, you were still secure. Some poor kid that looked about 12 years old got separated from his parents and appeared at the door alone. He apparently wanted to walk back up to the terminal to try to find his parents, but the guy in latex gloves literally jumped in front of the doors and told the boy he had to go out! The poor boy looked like he was going to pee himself and the middle-aged guy was acting like the 12-year-old had an AK47 strapped to his chest. So to make a long story short, Nazi-security-guard made the little boy go out the doors and stand by himself by the baggage carousel until his parents appeared some 20 minutes later looking quite disheveled. This was probably because the parents had been frantically searching for their 12-year-old son for 20 minutes. Right before our friend came through the door, there was a changing of the guard. The middle aged woman was replaced by a young boy who looked like Napoleon Dynamite. The middle aged man was replaced by a twenty-something girl with a huge attitude problem. Well, I don't know about you, but I can certainly sleep better tonight knowing that Barney Fife is protecting our airports!

The Spawns of Satan...Drug Reps

I have met the spawn of Satan, and they are drug reps. These are the people that drug companies pay to push their products to physicians, nurse practitioners, physician assistants, pharmacists, and other individuals in the health care field. The problem with drug reps is that they aren't physicians and they certainly aren't pharmacists. They're salesmen - no different than Joe Schmoe trying to sell you a new car. The only difference is that when the car salesman swindles you into buying the car, you're stuck with the lemon. When the drug rep swindles a physician into using their product, the public is stuck with the lemon. Today at the pharmacy I encountered a case that I feel is directly related to a Levaquin drug rep. A mother called the pharmacy and wanted to know the price of 9 Levaquin 250mg tablets. I told her the price is $117. (No, you read that right - I said $117 for nine tablets) She was understandably upset. She informed me that she and her daughter had $40 to their name until Friday. I explained some options to them. #1 - I could call her doctor and have the prescription switched to Cipro. #2 - I could sell her 3 Levaquin tablets which would get her through until Friday. The mother preferred option #1, however she was concerned the doctor would not switch. I reassured her that usually when told the patient cannot afford the medication most doctors will switch the drug. She told me that the doctor was very adamant that the patient needed this medication. Her daughter's urinary tract infection had spread to her kidneys and he told her this was the only medication she could use. Even after she told him she could not afford expensive medication and that she only had $40, he still stated that she must use this medication. I told her I would try anyway. An hour later she appeared at the window with her 20 year old daughter and her son. I told her to give me a few minutes and I would call. I called the ER at the local hospital and asked to speak to the doctor's name on the prescription. The nurse acted funny when I asked for that particular doctor. I finally got her to tell me that this particular doctor was not at the hospital today. So to make matters worse, a physician's assistant had seen the patient and used a doctor's prescription pad. Another physician in the ER promptly got on the phone. He agreed with me that the medication should be switched and was not happy that this woman had been given Levaquin in the first place. Sounds to me like the physician's assistant was prescribing what the drug rep had pushed. When I checked the price for 14 Ciprofloxacin 500mg tablets, the cash price was $46 - significantly less than the Levaquin. When I told the mother, she kept thanking me - as did her daughter and her son. I was concerned that the price was $46 - $6 more than she had. The mother had brought her credit card in case the doctor would not switch it. She was going to buy the Levaquin one pill at a time so that her daughter would have medicine. How sad is that??? It was really upsetting for me. If drug reps only knew the ripple effects of their fancy dinners and receptions... They never see the people that are directly affected by their greed. How do these people sleep at night?

Purdue Spells "A-D-D-I-C-T-I-O-N"

On December 12, 1995, Purdue Pharma's drug named Oxycontin received FDA approval and thus changed the face of prescription drug abuse forever. Purdue Pharma had an ingenious idea - place oxycodone in a controlled release formulation that allowed the patient to take it just twice daily, as opposed to every 4-6 hours. Apparently the R&D team stopped thinking at this point... Controlled release formulations are neat little drugs - however they come with one serious drawback. It you chew, crush, or in any way damage the tablet, the "controlled release mechanism" is ruined. Without this mechanism, the entire dose of the drug will be released at once rather than over a twelve hour period. While Purdue Pharma's R&D team apparently did not pick up on this oversight, millions of drug seekers quickly did. Thus "Hillbilly Heroin" was born. Before you start feeling sorry for Purdue Pharma, allow me to explain how the R&D team could've side stepped this disaster if they wanted to... But first, some background pharmacology! (This is my heart and soul right here...) Oxycodone is a narcotic analgesic that interacts with opioid receptors inducing analgesia and sedation. Opioid receptors are also associated with other effects such as euphoria, nausea, and constipation, to name a few. Nalaxone is an opioid antagonist. When this drug enters the body, for lack of simpler terms, it stops the effects of the opioid receptor. Nalaxone is most often used in overdose situations. Also, when nalaxone is in the body, opioid drugs cannot bind to the opioid receptor thus rendering the user inable to achieve euphoria. Now back to how to fix the problem - all Purdue Pharma had to do was add nalaxone to the extended-release oxycodone formulation. This nalaxone would only be released if the tablet was crushed or chewed. Viola! Did they do that? No. So, this leaves many to believe that Purdue Pharma was not doing all it could to stop addiction. While they did not advocate the misuse of their drug, they also did not do anything to stop the abuse either. On September 24, 2004, Purdue Pharma received FDA approval for another narcotic analgesic product - Palladone. Palladone is an extended-release formulation of hydromorphone. Instead of being tablets, Palladone comes in a capsule formulation. The R&D team once again fell short of preventing abuse of their drug when they designed the Palldaone formulation. Now instead of having to waste all that energy crushing tablets, one can simply open their capsule and dump its contents onto the heating spoon. Another innovative, abuse inspiring product from Purdue Pharma. I can't wait to see what they come out with next!

25 Reasons I Love Small Town, WV

1. We still have a "main street" filled with little shops

2. This main street has 2 lanes

3. There is no hazy, gray smog filled sky

4. Over five generations of my family have been born and raised in West Virginia

5. I can be to the beach in 4 hours

6. I can be to the mountains in 10 minutes

7. Three letters - W V U!!!

8. Lightening bugs fill my yard on summer nights

9. I know my pharmacy customers by name

10. We speak when we see each other outside the pharmacy

11. Fall hometown football games (Go Bulldogs!!!)

12. I can be to Baltimore in 1 hour and 30 minutes

13. I live less than 2 hours from DC

14. We get four distinct seaons

15. Summer is riddled with church yard parties*

16. My dad still cures his own hams with our ancestors' recipe

17. Store bought country ham sucks compared to my Dad's!

18. At Christmas, our whole family treks out in the woods together and cuts down our own tree

19. My sister lives less than 5 minutes from my house

20. My brother lives less than 20 minutes from my house

21. My family roots are strong in this town

22. I worked at a cement plant to help pay for college doing manual labor - as did my brother and sister

23. My dad worked at this plant for 41 years

24. My dad's father was killed at this plant in 1962

25. Every Sunday, my whole family comes home for dinner**


*Yard parties consist of the church elders cooking homemade food, like pan-fried chicken, country ham sandwiches, homemade chicken noodle soup, and homemade ice cream.

**My parents had to buy a giant dining room table for these meals because when all my siblings and their families come home, there are 12 of us sitting at that table. I wouldn't have it any other way. :)

Mr. Harry Potter, if you please...

Yesterday at 11:35AM, I saw the mail lady pull up at my mailbox. I ran out of the house wearing my pajamas and rushed to the mailbox. When I pulled open the door, there he was...Harry Potter! Ok, I know, I'm 23 years old and this is supposedly a children's book. However, if you have read any of the books, you would know that this isn't just a children's book. So there he was in a white Amazon box with Harry Potter and the Half Blood Prince tattooed across the side and large green letters proclaiming "Do NOT deliver before July 16!" I retrieved the box and carried him carefully inside. I promptly started reading. I took a break only to go to Rail Days (a town event celebrating the Roundhouse at our train station). 217 pages later, I decided to call it a day. For all you Harry Potter fans - this is an awesome book (not that I doubted anything less from Ms. Rowling). I have to admit, I'm a late comer to the Potter party. I watched the movies first, and then read the books. The third movie left me confused and wondering what was going on. I bought the books to figure out what was going on. I have read the first five books twice and I can't put the sixth one down. They absolutely blow the movies away. I have since hooked my sister-in-law and now my brother into being Potter fans. :) Muhahaha }=>

Thieves and Plunderers

As I have stated in earlier posts, I have been away from my current place of employment for some time due to clinical rotations. In order to keep some money in my pocket, and my manager slightly sane, I have been working every other Sunday. I work on Sundays for two reasons - #1)I make $1 extra per hour and #2)We're open 10-4. Being an eternal night owl, 10AM is the earliest I like to make an appearance at the pharmacy. That being said, I have always respected the individuals that I work with. AL has been a technician at the store for several years and is a total sweetheart. The customers love her, our pharmacists love her, and I love her. She's a reliable person and a great co-worker. JC has worked for our company for many years, but came to the pharmacy last summer. She does her job and does it well. She's a reliable individual and I don't think I've ever been there when she's called in. SF is another pharmacy student. To protect the innocent, I am making no further comments on this individual. Finally, MP came to the pharmacy during a technician crunch. She was supposed to fill the eternally open evening shift. MP and I went to middle school and high school together. We never really talked in middle school and high school just shifted us further apart. She's worked for our company for several years, but like JC, is a transplant to the pharmacy department. Finally there are our three pharmacists - RC, CF, and MN. RC is pharmacy manager and CF and MN are staff pharmacists. All three are great pharmacists. Some have strengths that others lack - but trust me, from being on rotations and having worked in other pharmacies - these are 3 top notch pharmacists.

I gave you the background of the staff I work with so that we can play a little game of Clue. I arrived at work on Sunday to find my smock pockets conspicuously empty. This is extremely odd because I keep no less than 3 pens in my pockets. I also have a bad habit of keeping money and my register sign on number in my pocket. Of the 3 pens in my pocket, one was very special. It was a Plan B pen. This is my favorite pen. The other pen was a run-of-the-mill Risperdal pen and the last pen was a very nice Enbrel pen. Since the company that makes Enbrel charges $1500 for a month's worth of medication, they can afford better-than-average pens. (I'll post on disgusting drug companies at a later time) The Enbrel pen was given to me by my preceptor at Washington Hospital Center. It was a very nice pen. All three pens are gone. They were there the last Sunday I worked, which was June 26. Now, I pose to you this question - who stole my freaking pens??? The answers should be posed in a Clue-like fashion. Example - CF in the pharmacy with the Plan B pen. You can name individual pens or simply accuse a person of stealing all three pens. I will be returning to work on Monday and plan to post the correct answer on here. Because after Monday, everyone will know to keep their grubby paws out of my shit! :)

The Push for Stem Cell Research

On September 3, 2000, my grandmother passed away after over a five year battle with Alzheimer's Disease. We're not really sure how long she actually had the disease; however on a February day in 1999, it became quite evident that something was drastically wrong. For years previously, Nan would make off-collar comments or become easily confused. We chalked it up to forgetfulness and aging. We couldn't have been more wrong. That February day, it was more than simple forgetfulness. Nan regressed to her past - no longer recognizing the house she was living in and longing for her home place which she had not lived in for over thirty years. This was also the last day that she ever recognized my sister. My sister was her first grandchild, and therefore held a special place in my Nan's heart. It was devastating to my sister, as well as myself, to see Nan not remember her. Nan was no longer able to stay at home because she would wander out in the street and become aggressive when you tried to reason with her. I lost Nan that day...even though she died over a year later, I lost my Nan that day.

For anyone who hasn't experienced Alzheimer's Disease, I can't explain it to you. It is probably the only disease in the world that is harder on the family and caregivers than the actual patient. My family and I watched my Nan wither away to a shell of a human being. Had she been aware of what was happening, she would've been mortified. She would've been so embarassed by her aggressiveness and loss of inhibition. My mother barely made it through the experience. Of all my life experiences, Alzheimer's is by far the worst.

Today, Michael J. Foxx sat before the Senate and asked them to follow the lead set by the House and lift the restrictions on stem cell research. Foxx suffers from Parkinson's Disease - a disabling neuromuscular disease. Stem cell research holds the most hope for cures for a long list of diseases, including Parkinson's, Alzheimer's, and cancer. In 2001, President Bush imposed restrictions on federal funding for stem cell research. Along with these restrictions came a ban on federal funding for new human embryonic stem cell studies. In a nutshell, only stem cells donated from umbilical cords can be used for research purposes. The problem with these cells is that some of them have already begun to differentiate, therefore limiting the potential benefit of these cells. Other key figures pushing for a lift of these restrictions include First Lady Nancy Reagan, Mary Tyler Moore, and Dana Reeve (wife of the last Christopher Reeve). President Reagan passed away after a long battle with Alzheimer's Disease. Mary Tyler Moore suffers from Diabetes. Christopher Reeve was a quadriplegic. All of these individuals may have benefited from stem cell research.

Senator Arlen Specter, a Republican from Pennsylvania, has been instrumental in bringing forward the bill to lift these restrictions. Specter suffers from cancer. Sentator Tom Harkin, a Democrat from Iowa, is the co-sponsor of this bill. The House passed this bill on May 24. The Senate is debating bringing it to the floor. Unfortunately, President Bush has vowed to veto the bill. The bill passed in the House with a 238-194 vote, way short of the 2/3's required to override a Presidential veto. It is uncertain whether the Senate can amass a 2/3's vote either. Unfortunately, though this bill has bipartisan support, it may be vetoed. A veto would truly be a loss for individuals suffering from Parkinson's, Alzheimer's, and cancer.

Why Meth is Inconveniencing Me

I went to work on Sunday to find that every pseudoephedrine product from our over-the-counter section had been placed behind the counter. Having been on clinical rotations for the past eight weeks, I haven't been to work in a while. Apparently in my absence, WV passed a law requiring all products with pseudoephedrine as their only active ingredient be placed behind the pharmacy counter. In order to obtain said products, you must produce photo identification and sign a ledger. The pharmacy must also report all individuals who purchase these products to the State Board of Pharmacy for tracking. The amount of product that can be purchased is also limited. Individuals can only purchase three packages, or 9 grams of pseudoephedrine, each month. This law was passed to help curb the growing methamphetamine problem in this state. Meth labs aren't just a WV problem, they're a nationwide problem. WV just happens to be following the lead of several other states that have passed similar laws. Ok...that being said - this is a pain in my ass. It's a pain for the pharmacist in me as well as the consumer in me. I am so sick and tired of being punished for drug addicts' actions. We're forcing the public to be inconvenienced to stop a few people from cooking meth. In this ever losing war on drugs, you'd think we'd learn that these people improvise! I'm sure limiting the sale of pseudoephedrine will not really curb meth cooking all that much. Now my pharmacy isn't just at risk for being robbed for its Oxycontin, now the freaking meth heads will come hold us up for our pseudoephedrine! This is just another injustice served on society by drug addicts. I can't sell needles over-the-counter anymore because of drug addicts. I'm sure there are legitimate insulin users who come to my counter who are out of needles and don't have a prescription. I can't sell them needles because our store made a policy banning the sale of needles without a prescription. Finally, as a consumer, this just royally pisses me off. I don't want anyone tracking my name and my cold product usage. I hold a license from the Board of Pharmacy; however I really don't think it's any of their damn business if I have a cold or not. Again I must state - legalize it, tax it...and stop inconveniencing law-abiding citizens!

Generation Rx

Like a good student pharmacist, I try to read material from professional organizations on a regular basis. As a member of APhA, I get a magazine entitled "Pharmacy Today." Slapped across the front page of the June 2005 issue (ok - so I am a little behind on my reading!) is an article regarding medication abuse among the nation's youth. I find this quite troublesome. The 17th annual study of teen drug abuse conducted for the Partnership for a Drug Free America found that several prescription and over-the-counter medications trailed only marijuana in abuse by teenagers. Of the 4.3 million teens surveyed, 37% had used marijuana; 18% had used Vicodin; 10% had used Oxycontin; 10% had used Ritalin or Adderall; and 10% had used cough medications containing dextromethorphan for a high. The prescription medications listed were not prescribed for the teenagers. Another survey conducted by the National Institute of Drug Abuse, which is conducted annually among 8th, 10th, and 12th graders, found similar results. At this point, I should probably explain the significance of the drugs listed above. Vicodin contains 5mg of hydrocodone and 500mg of acetaminophen. It is a Schedule III drug. Schedule III means that the drug has abuse potential less that drugs listed in Schedules I and II; however abuse of the drug is dangerous. Abuse can lead to moderate to low physical dependence or high psychological dependence. Oxycontin contains oxycodone in a controlled release formulation. Purdue, the manufacturer, so graciously made the medication extremely easy to abuse. See - if you crush the pill, you destroy the controlled release formulation and essentially dump the entire dose of oxycodone at once instead of the normal slow release over a 12 hour period. Purdue really doesn't care that it's easy to abuse this drug because their profits are sky high. Whether the drug is being used legitimately or not, they still reap the profits. Oxycontin is a Schedule II narcotic. Abuse has the potential for severe psychological or physiological dependence. Here in WV, it's referred to as Hillbilly Heroin due to it's heroin like high when crushed and main lined. Ritalin and Adderall are stimulatants containing methylphenidate and amphetamine, respectfully. They are typically used to treat Attention Deficit Disorder. They are classified in Schedule II as well.

After reading this article, I asked myself, "Why are kids doing this?" As a teenager, I never experimented with drugs. I've never smoked a joint, I've never rolled E, and I certainly have never dropped acid. I never really had a desire to do any of this...and I always knew that if I did do it and got caught, my parents would seriously kick my ass. So why are kids doing this? Personally I think it's because society accepts prescription drug abuse. Abusing legal drugs doesn't carry the stigma with it that abusing illicit drugs does. For further proof, just examine the federal and state drug laws. In regards to prescription drug abuse, the penalties are merely a slap on the wrist compared to illicit drug consequences. Finally, I can't help but wonder if the use of stimulant drugs in children isn't to blame. So many of America's youths are on Ritalin, Adderall, or Concerta. These drugs are hard core stimulants. I can't help but wonder if they aren't "wiring" the brain for abuse. I've seen kids as young as five on these drugs. And the really sad cases are the kids who take these medications three times a day and then require another medication to sleep at night. These kids have the deck stacked against them from day one. I don't think soceity sees the consequences of this practice yet. It's a relatively new concept - stop being a parent and start medicating your child. (Disclaimer - There are children with true problems, that probably require these medications. However, work one day in a retail pharmacy and then tell me if you think these medications aren't being substituted for parenting. I guarantee you that you will agree with me.) Where will these kids be ten years from now? Twenty? Thirty? If these kids are abusing Oxycontin in the teen years, what the hell will they be dawdling with in their twenties? It's a scary thought...

Mission: Accomplished

My second clinical rotation drew to an end yesterday. As usually is with my life, parting was bittersweet. I started the rotation not enthused. I even wrote a letter to the experiential coordinator at my school complaining about having a retail rotation as a selective. I have long suffered from "foot-in-mouth" disease, and following suit with this infliction, I learned that this was probably the best selective I could've had. This rotation site wasn't just retail - it truly was an all-encompassing pharmacy. They had a durable medical equipment department, a retail pharmacy, a home infusion company, and they also served as a "warehouse" for all the doctor's offices as well as the surgery center for the facility. It really was a neat place to work. Before this rotation, I never had experience making IVs. On my evaluation, my preceptor wrote that I was more than competant to prepare IVs, PCA bags, and chemotherapies. Yes...I said chemotherapy. During this rotation I was provided with the opportunity to compound 5-FU. My sterile compounding professor is going to flip. She gave me an introduction to chemo, but told me that I would never make it on rotations. HA! My fourth week at this rotation, I was gowned up, masked down, gloved, and in the hood making chemo. It was awesome. At this rotation I also got to stregthen my compounding skills. I made two solutions for burning off gential warts. Fun stuff!

At lunch yesterday, my co-workers shocked me by having me a "going away" party. They all went together and purchased 2 6-foot subs and baked all kinds of goodies. Before I could get food, they made me promise that I would come back and be a pharmacist there. (Awwww!) When I told them I would seriously consider it, they all cheered. They gave me a "good luck" card with all their well-wishes in it. When I went in for my final evaluation, my preceptor informed me that her technicians told her that if she didn't give me a great grade, they would beat her senseless. (These are the greatest techs I have ever worked with.) I walked out of the evaluation wit a 99 and another job offer. My preceptor called the owner of the pharmacy and told them she had a pharmacist she wanted to hire in May 2006 and that I could only work for her. At 5:00, when I walked out of the pharmacy for the last time, they all bombarded me with hugs and made me promise to come visit. I told them that I'd definitely be back...even if it was just for a lunch party! :)

Residency? What residency??? ;)

Peace on Earth?

I awoke this morning to find that London, England had been attacked. At 6:00AM EST, it was still unclear whether or not it was a terrorist attack and no one had claimed responsibility. I turned on CNN and my heart just ached. Why do we kill each other? What God would want his followers to kill in his name? This world is absolutely toxic with hate. Hate breeds hate. Killing breeds killing. The world is headed on a downward spiral and I'm awfully afraid that if we don't pull out of this hate whirlpool soon, it will be too late. My thoughts and prayers are with the people in London. This morning watching the chaos in London, I couldn't help but think of a saying I once read on a bumper sticker - "God wants spiritual fruits, not religious nuts." Amen...

Pharmacist "Unconscience" Clause

Here, here to the American Medical Association. In light of this "conscientious objection" crap, the AMA has finally said, "Enough is enough!" This past spring this so-called "pharmacist conscience clause" got a lot of press. Apparently there is a group of pharmacists that feel that they should push their personal beliefs on people instead of practice pharmacy. This entails Catholic pharmacists having the RIGHT to refuse birth control prescriptions, and pro-life supporters to refuse Plan B prescriptions. This group of pharmacists has apparently decided to through "patient care" out the window and stomp all over the sacred "patient-physician" relationship. In response to this "conscience clause," The AMA decided last week to draft and adopt a policy that directly addresses this "objection." The new policy supports legislation that would require pharmacists to fill all valid prescriptions or immediately refer patients to another pharmacist; directs the AMA to enter into discussions with pharmacy organizations concerning matters of conscience; and in the absence of all other remedies, to work with state medical societies to adopt state legislation allowing physicians to dispense medication when there is no pharmacist willing to dispense the medication within a thirty mile radius. Since pharmacists are no longer able to "police" themselves, I think it's high time that another medical profession stepped up and slapped us in the face. Let's hope APhA follows suit...however I'm not holding my breath. APhA has been pussy-footing around this issue since January. It's a sad state of affairs when a pharmacist can tell a patient they won't fill their prescription because it's immoral. With policies like these, it's not wonder we're not getting respect from physicians.

Along these same lines, I noticed today at my rotation site that Plan B is conspicuously absent from their stock shelves. However, generic Cytotec is kept in stock by the hundreds. Today I found out why. I took a prescription from a doctor's office for "Cytotec 100mcg - Take 4 as a single dose in the physician's office." As soon as I read it, I knew what it was being used for; however, the pharmacist I was working with was at a loss. She was highly concerned about such a high dose. Finally, I looked at her and said, "It's not being used for ulcer prevention and it certainly isn't being used for cervical ripening. It's being used to terminate an early term pregnancy." The light clicked on in her head and it finally made sense to her. I had no problem whatsoever dispensing the medicine - and apparently neither did the pharmacist. However, I do find it a bit odd that a pharmacy that refuses to stock Plan B will dispense Cytotec...a drug strikingly similar to RU-486.

The ONE Campaign

Tomorrow, July 2, marks the beginning of a series of ten concerts that will be played simultaneously around the world to raise awareness of the G8 summit. An Irish rocker named Bob Geldof organized the event, along with U2 front man Bono. Geldof announced yesterday that they were just $2 billion shy of the goal of $25 billion for aid to Africa. He truly believes that these concerts will be the final push to achieve their goal. Geldof originally believed that the Live 8 concerts would be the beginning of the rally call.

Running along these same lines is a campaign entitled "The ONE Campaign." This campaign is not based on money as much as voice. Below is the transcript from their video that is airing across America. Please read it, then visit the website, and finally sign the promise and the letter to President Bush. This is not a liberal campaign or a conservative campaign. It has huge bipartisan support. If you don't believe me, watch the video. Sean Penn, Bono, Ellen Degeneres, and Pat Roberston are all standing together and calling for help on this issue. I signed the petition, I signed the letter, and now I'm sharing the cause with you.

"One by one they step forward - a nurse, a teacher, a home maker - and lives are saved. But the problem is enormous. Every three seconds one person dies...another three seconds, one more. The situation is so desperate in parts of Africa, Asia, even America, that eight groups, just as the did for the tsunami, are uniting as one...acting as one. We can beat extreme poverty, starvation, AIDS, but we need your help. One more person...letter...voice, will mean the difference between life and death for millions of people. Please join us by working together. Americans have an unprecedented opportunity. We can make history. We can start to make poverty history. One...by one...by one. Please visit One at this address: http://www.one.org. We are not asking for your money – we are asking for your voice."
~ONE Campaign

Ye Old Week From Hell...

My life is riddled with unfortunate events (for further examples - see posts entitled "A Series of Unfortunate Events" and "Ahsirt Meets Murphy"). Yesterday I was diagnosed with the flu. Ok - it's the middle of summer, it's freaking 90 degrees - how the hell did I get the flu??? Consequently, I missed one and a half days of my second rotation. This all started Saturday night. Around 6:00, I began to feel as though I had been beaten, which was quite odd because I didn't remember fighting anyone or being bludgened with a bat. Sunday morning I arose to feel, for lack of better terminology, like shit. I drug myself to work because I couldn't let CF down. CF is one of the pharmacists I work with. He gets a little flustered when the wait starts piling up, so I just pictured him having a mental breakdown and being carted away in a straight jacket if someone didn't come in to at least run the register. By lunch time Sunday, I felt considerably better and was actually thinking that perhaps my slight hangover from Friday night was to blame. This was all dispelled Monday morning when I woke up and could barely walk. For the next three days, my being able to stand up relied solely upon me taking at least 600mg ibuprofen every 4 hours (as you will find out later, this totally fried my stomach). By Wednesday, I was pretty bad. I almost fell asleep in the car on the way to work. This is a scary sensation. I was driving along and the music was getting softer and softer and the car got warmer and warmer and then RUMMMMMMMMMMMM - I hit that damn strip that wakes you up. Pshew! Thank God for that little thing. I made it until 12 and had to go home. I couldn't even get the lids off the stock bottles I was so weak. Thursday morning when I woke up, I still felt much like shit, so I called in sick and took myself to the doctor. He promptly diagnosed me with the flu and told me to drink plenty of water. He also told me that my stomach was inflamed and to stop taking ibuprofen and please take acetaminophen. I hate Tylenol. So...I started taking Prilosec OTC every morning and cut back on my daily intake of ibuprofen. :)

The final hit below the belt for this week - I have probably killed my preceptor. She is a double organ transplant receiver. She has her brother's kidney and a 16yo's pancreas. She's well controlled on immunosuppressive drugs and I totally exposed her to the flu. I hope the incubation period is longer than seven days, because I think that may be detrimental to my evaluation.

On the positive side, my preceptor said all would be forgotten if I would show up at 7:30AM on Tuesday rather than 8:30AM. I think that's a pretty good deal...except Monday is our 4th of July party and we've got two 1/4 kegs sitting in our kegrator just calling my name. And...I'm supposed to be making chemotherapy Tuesday morning. This should be real nice.