Black Market Body Parts

In a story that reads like a "B" horror film, Biomedical Tissue Services has been dealing in stolen body parts. Four individuals have been charged with body stealing and opening graves, unlawful dissection, and other counts. They were stealing bone and tissue from bodies and then falsifying consent and death certificate documentation. To replace the stolen bone, the individuals shoved PVC piping and other random materials into the bodies. It is unbelievable that so-called grave robbers exist in the 21st century. Not only have these men raped and pilaged human cadavers, but have placed hundreds of innocent individuals at risk for infectious disease such as hepatitis C and HIV. The individual's femurs have been replaced with PVC piping. The man delivering the bodies received $1000 for his trouble, and the broker for the stolen tissues made up to $7000 per body. The picture above is an x-ray taken of one of the pilaged cadavers. No surprise - the four individuals charged are pleading not guilty. Another big surprise - the FDA is downplaying the severity of the issue stating that the risk of HIV and hepatitis C is "minimal."

The Greatest Reward

Last Thursday I met a very special individual at my Am Care site. "Scooter" is a mentally-challenged adult who lives in a care home. Several years ago, he had a mechanical valve in his heart and consequently requires life-long Coumadin therapy. He has always been very well controlled on Coumadin...that is until two weeks ago when he got sinusitis. Scooter did not tell the Urgent Care doctor that he was on Coumadin. The doctor prescribed Bactrim DS - which significantly interacts with Coumadin. When Scooter came in for his monthly INR check two weeks, his INR was 4.9. When he was told the INR value (he always wants to know the number), he cried. He was so upset over his INR value that he burned his popcorn every night that week. Once it was so bad, the fire department came. Consequently, he lost his job as "popcorn popper" at his care home. He was devistated. Last week when he came in, his number was down to 3.9, but was still high. He started to cry again. I explained to him that his INR was not his fault and that it certainly was nothing to get upset about. We sat and talked about his INR and what makes it go up and down. I again explained that his INR was not his fault. He thanked me and thanked me. Today he came back to the clinic. His INR was 2.9. Woohoo!!! When I went to get him from the waiting room, he handed me a card. It was a thank you card that he had addressed to me and my preceptor. He said the world was a better place because of friends like me and KM. Icing on the cake - he got his job back as popcorn popper and is getting an award for his dedication. That is the greatest reward I could ever receive. :)

A Nice Place in Hell for Fred Phelps

Here's a story that will make you sick. There is apparently this group of religious nuts that have decided to hold protests at fallen soldiers' funeral. First and foremost, there should never be a protest at a soldier's funeral - regardless of the purpose. That being said these protests are not even pertaining to the war and whether it's right or wrong. Reverend Fred Phelps and his congregation of family members holds anti-gay protests at fallen soldiers' funerals. Phelps believes that God is punishing America for "harboring homosexuals." His protestors carry signs thanking God for the IEDs that kill our soldiers. At a recent memorial service at Fort Campbell, these protestors wrapped themselves in upside down flags and chanted songs with vulgarities about homosexuals and soldiers. In response to state legislatures drafting laws to prohibit their protests, Phelps daughter made the following statement: "The scriptures are crystal clear that when God sets out to punish a nation, it is with the sword. An IED is just a broken-up sword. Since that is his weapon of choice, our forum of choice has got to be a dead soldier's funeral."

I am totally appalled. First of all, the war in Iraq has NOTHING to do with homosexuality. Secondly, I am so sick of this "God is punishing us" shit. Homosexuality is NOT wrong. It is NOT in the Bible. Finally, I'm not a theological scholar by far, but I believe the whole "judging" thing is up to God himself - not dimwits like Phelps. I think God has a special place in Hell for Phelps and all his nut followers.

Am I Wasting Your Time?

Mondays are usually my afternoons in the clinic. Today was a little different. My preceptor gave a lecture on chronic kidney disease to the P2s today from 1-3, so that pretty much killed our clinic time. We did have a 3:00, a 3:45, and a 4:00 patient. After the lecture, she and I rushed to the clinic so as to not make our 3:00 wait. This was, however, in vain because our 3:00 canceled. The 3:45 patient was a Medicare Part D consultation and the 4:00 was a Coumadin adjustment. I went ahead and pulled the 3:45's medication list and found her 3 potential Medicare plans. It was more like 4:00 when she finally got there. As I was explaining the concept of premiums, deductibles, and copays, it was blatantly obvious that this poor woman had NO idea what I was saying. I could've been speaking Latin and she wouldn't have known any difference. I tweaked my approach to focus on her cost-savings. I tried to explain that she was paying over $100 per month just for one of her scripts and with the plan, she could get all 8 prescriptions for $1400/year. Her glazed over eyes kind of cleared and she said, "$100?? I don't spend $100." Having worked retail, I knew this drug cost over $100 per month. When I asked her how much she did pay, she replied, "$3." At this point I knew something wasn't right. I asked her for the second time if she had prescription insurance and she said, "No. Well, I do have this program I qualify for because my husband was in the Navy, but it's not insurance." I said, "Is it called Tricare?" She said, "Yes." And at this point, I beat my head on the counter. I informed her that Medicare Part D would be a waste of her time...unfortunately, it was too late for my time at this point.

Life in Ambulatory Care

Having spent over 16 weeks in a hospital environment, I have found the ambulatory care world a bit shocking. Life in the hospital is pretty controlled - nurses titrate your IV drips, nutrition feeds you, and doctors examine you. However, ambulatory care is anyone's game. When turned loose in the world, the average patient is non-compliant with their medication regimen and their diet. They may come in to see the doctor when their leg falls off from gangrene. Today I spent an hour with a lady who I came to find out is not taking any of her medicine. She brought me her medicine bottles - all of which had labels stating they were last filled on 11/30/2005 except the potassium which was filled 5/24/04. When I questioned her, she replied that she just dumps her new pills in her old bottles. Having worked with patients like this before, this wasn't surprising. I called the pharmacy...yea, she hadn't had those pills filled since November and the potassium hadn't been filled since 2004. Best part - her insulins hadn't been filled since March 2005. Did I mention she's a type 2 diabetic? Consequently her sugars are through the roof and her kidneys are shutting down. I tried to explain this to her. Her response - "That pharmacy is lying on me!" Yes that's right, the pharmacy is out to get you! *Sigh* My final patient of the day had mixed his Prinivil and Zocor in the same bottle because the pills were somewhat shaped the same way. Actually, they're not shaped the same way. His Prinivil 10mg is tan and a trapazoid. His Zocor is pink and shield shaped. So apparently, whatever pill fell out of the bottle each morning is what he took. Best part - he had another bottle of just Zocor which he took each night. Put it together and some days he was taking Zocor twice a day. But, at least he was taking them!!! I know it's a long day when I rationalize this behavior with, "Hey, at least he took them."

The Sadist and the Olympics

I'm usually not a big winter Olympics fan, but I have to admit, I've been hooked these past couple days. The USA women's hockey team has been pretty exciting to watch. It's a confidence booster to watch muscular women skate around and kick some ass. It's a shame that women like this can't be role models for young girls, as opposed to waifs like Britney Spears. I've also watched some downhill skiing, cross-country skiing, luge, figure skating, speed skating, and (hold your breath for this one) curling. I only watch figure skating for one reason - the falls. Having ice skated before, I can respect the talent it takes to pull off the moves; however it's much more fun to watch them fall. I think secretly, most people watch figure skating for the falls. So, I guess you could call me a Sadist. :)

Finally, I got great pleasure last night from watching Bode Miller miss the gate in the slalom. He is exactly the opposite of what an Olympic athlete should be. First of all, he admitted to skiing drunk. Anyone that has skied before knows how stupid that is. Once the public became enraged by his comments, he changed his story and said you couldn't ski drunk. Nice save... Then, he started accusing other athletes of doping - Lance Armstrong, Barry Bonds, and the best one - Jesse Owens. He has acted like a pompous ass in Torino - staying out late drinking and missing inspections in the morning. His cocky attitude is finally being served. He missed a medal opportunity in the downhill and yesterday he D/Q'ed himself from the downhill combined when he split a gate on the first slalom run. How fitting. He does seem a bit humbled by his mistakes. I say, too little, too late.

Beginning of the End

Day 1 of my last rotation went off without a hitch. I'm glad they saved this rotation for last, because it would've spoiled me had it occured early in the year. Let's see, I have clinic on Mondays from 1-4, Thursdays from 9-4, and Fridays from 9-4. Wednesdays are personal days and Tuesdays, well I only have to show up for a 2 hour disease state discussion. It's a much welcomed end to a long, hard year. Plus, my preceptor is pretty awesome. We sat around and chewed the fat this afternoon. She's got a pretty good sense of humor, so I think she fits the attitude I have for this rotation. This rotation is also a hodge podge of things - anywhere from Coumadin adjustments, to HTN med adjustments, to Medicare Part D enrollments. I like a little variety in my life. The office staff is a lot nicer than previous staffs I've encountered. They are actually excited about my nursing in-service (a real first!). Now, I've just got to stay focused for 6 more weeks...

Another Bites the Dust

Yesterday marked the final day of my sixth rotation. I bid farewell to the hospital I've been roaming in since November. It is a potential residency site, so perhaps goodbye wasn't forever. Although the beginning of my week started off quite comical, the end of the week was more somber. My bare-ass patient remained his spunk self, even offering to show me his bruised genitals. I passed. My other patients were quite ill and in no mood for comedy. It was quite sad. My preceptor has been MIA for hours at a time these past two weeks, and yesterday I found out why. He has canceled all other rotations, denied to be an advisor for practicum projects, and closed his Coumadin clinic indefinitely on Fridays. Needless to say, he's been away with reason. My evaluation was on level with previous ones. It included phrase like, "Quite frankly the best student I've ever had" and "Highly recommend her for any residency position she desires." I was flattered, as always - as well as humble. Every rotation I complete, I find myself loving pharmacy more and more (which is definitely a good thing). I was unsure if a residency would put me on the correct path; but now 6 rotations and several interviews later, I'm sure of it. Next week I can submit my selections, and I already have the list made up. I finally feel set in my future.

Can I Borrow Your Hose?

Following along with my prevoius post, my personal life is also quit crazy right now. This afternoon the doorbell rang. I opened the door to find the 18yo neighbor boy standing on my front porch (for further details about the neighbors from hell, see previous posts). He asked me if I had a piece of hose he could borrow to ciphon gas out of a car. Apparently the blank and slightly appalled look on my face took him by surprise. Being a pharmacy student, my first thought was not that he was going to steal my gas (which it probably should've been) but that he was going to suck gasoline into his mouth. Before I could educate him about the dangers of allowing petroleum-based products to enter the body, he was explaining that his friend had a car that was undriveable and had a full tank of gas. They simply wanted to get the gas out of the tank since gas is so expensive. It was at this point that I remembered the day last week when my father's gas tank cap was ajar and gas was missing from the car. I almost said, "AJ, did you lose the hose you ciphoned my gas with???" But...I didn't. My father came over and dug out a piece of hose to go help the gangster kids. Much to my surprise, and much to the relief of the pharmacist in me, AJ and his friends had a vacuum pump at the ready to ciphon gas. The gasoline was not going to come into contact with their mucous membranes! Then it dawned on me...what are a bunch of 18yo hoodlums doing with a vacuum pump?! You know you are totally immersed in your career when your concern for someone else's health and well-being supercedes your common sense for being ripped off.

Show Me Yours...

Today marks the second day of the last week of my sixth rotation. As with all other rotations, it's promising to go out with a bang. So far this week, I've been mooned, lost my preceptor, and watched a man just 4 hours after a heart attack lick PURE butter off his lips. Allow me to elaborate...

Being Mooned - Last week a 55yo WM came in to the ER complaining of severe leg pain. To make a long story short, he had a massive clot in his left leg which had totally occluded blood flow to the entire leg (hence the pain). He was given infusions to bust the clot and eventually had to have the clot surgically removed to save his leg. Yesterday, he was going for a walk down the hall...with his entire ass hanging out of the gown. Ok, it might be normal for a senile 88 yo man to walk with his ass hanging out, but it is NOT normal for a 55 yo man with good sense. To add insult to injury, he walked up to me and asked me to tie his gown for him with a twinkle in his eye. Thankfully my rotation partner, who happens to be male, stepped in. I had seen enough ass for one day.

Losing My Preceptor - He wanders aimlessly around the hospital and is time challenged. This usually doesn't bother me...unless it's 7AM and my ass is on time.

Licking Butter - I went in to talk with an 89yo WM this morning about his new Plavix therapy. At the time he was eating breakfast (which by the way is the most horrible smelling thing at the hospital - no matter what is on the tray). He took a break from his scrambled eggs and bacon only long enough to butter his toast with FOUR butter pats. There was so much butter on the toast that it left a milk-like mustache on his upper lip. I couldn't stop staring at it. And then found myself trying to control laughing at the totally absurd picture. I mean, honestly, here I was explaining the Plavix to keep his stents open, and he was eating butter by the gallon. I digress...