But I’m Just a Tech!!

Sorry to the three people who read this on an ongoing basis. I have been very delinquent. A few relationship issues, working some overtime at another store to fill in for another tech who quit 3 hours before her shift, and getting so tired and worn down and getting sick from working so much and still trying to have somewhat of a life with my family have all taken their toll on my desire to write.

I just want to say that I think my personal physician is pretty cool. I thought I had a sinus infection, but with a few looks and taps and pointed questions he sent me on my way with a nasal corticosteroid. A lot of doctors would have given someone with my set of symptoms out the door with an antibiotic just to placate them. Mine wouldn’t… just the Nasonex. Now every time I do my snorts, I imagine the little bee with the Spanish accent saying it.. NASONEX!!.. Now that is good advertising!

Well… this tops it. For the length of time I have been in the pharmacy business, today we had the rudest person EVER. A very well dressed, older couple approached the counter while I was holding with an insurance company. I said that someone would be right over with them, and the pharmacist was, indeed with them in a short period of time.

Their situation? They were traveling and hubby was running out of his medication. They’re from the good old U. S of A. and they neglected to bring a proper amount of medication with them. They handed over a few bottles with labels on them to the pharmacist. Diovan and Metoprolol. One from a pharmacy inOttawa, dated from weeks ago for a very short supply and another from a pharmacy in the same province we are in, but prescribed by a pharmacist for 20 days worth of medication. This obviously means the people have known for probably close to three weeks that they should perhaps try to find a doctor to reissue a precription.

First things first. Yes, a pharmacist can help out by extending prescriptions or giving emergency supply medication. For people we know… or for people whom we can get documented rxs written by a physician.

Since these people are from New York.. we can’t help by extending the rxs, especially since they have been extended once already by another kind pharmacist. So, the pharmacist gets on the phone to the pharmacy in Ottawa that filled the rx three weeks ago. She gets the number of the physician who prescribed it. Then she calls the doctor to try to get a further extension on the rx. And is put on hold. He is gone for the weekend, it seems. Of course, they are 3 hours ahead of us. The receptionist jumped through some hoops to try to get another doctor to give an rx, but since no body knows who these people are, of course we don’t get one. I think finally the receptionist must have paged the doctor and he got on the phone. He has NO clue what we are talking about… he is an orthopedic surgeon.. why the hell would he have written an rx for a “heart medication” for a total stranger??? Dead end!!

Meanwhile the couple is leaning on the counter (blocking our entire drop off window)speaking in some foreign language.. I hear some German (which I speak) so I was trying to eavesdrop to see if I could figure out what they are saying. No luck, as only a word or two was German… maybe it was Yiddish?? Africaans? I don’t know. But in any case, I was asked to call a local Doctor’s office and try to get an appointment for this couple for today. It’s tough enough to get an appointment with your OWN physician in this city within a month or two, let alone getting an appointment for strangers for the same day. After waiting on hold for about 10 minutes, I finally speak to someone who says the doctor could see the person tomorrow.

We suggest to the couple that they could take one of these appointments, or make a stop at one of the local walk in clinics to get a new rx for their medications. They say they already have to go on Monday.. but they only have one pill left. We reiterate that they can see the nice doctor down the street tomorrow… but they don’t want to go there. They will go Monday.. but they still have to find a doctor to see. They are vehement that they have had to do so more than once on this trip, and every time they do, they have to pay 100-300 bucks for the office visit. Well… if you had had some foresight, and brought enough medication with you… this wouldn’t have happened!!!

Meanwhile we have filled a prescription for this couple’s friend/relative who has just been to a dentist for some obviously major work. She is from Toronto. This couple obviously gets around. If you have enough money to be traveling many many miles across the entire country of Canada…. having a few dollars to see a doctor shouldn’t be a problem. The pharmacist has now suggested that they DO go to the medicenter, at which point Papa nods and walks away. No “thanks for your time” “I appreciate what you have done” nothing.

Meanwhile Mama is wandering around the store calling for Papa, in the loudest possible voice. They reunite not far from the pick up window, and they come back to the pharmacist and Mama starts yelling about how we are not helping them. “what if Papa has a heart attack. It will be YOUR fault!! He is a sick sick man and you need to give him some medicine!!” Wait…. it’s OUR fault if Papa is sick? If he is so damned sick… stay home! If he is SO DAMNED SICK.. go to the hospital… or a doctor… cost shouldn’t be an issue. Why the hell would someone who could fall down and have a heart attack on the spot because they miss ONE day’s worth diovan and metoprolol, not go the hell back home when they found out instead of wandering around the whole country?

As I think I said in an earlier blog entry, I understand things can go wrong and you can neglect to take enough medication with you when you travel under extenuation circumstances. We bent over backwards for these people.. making multiple long distance phone calls ( one of which was at LEAST 1/2 hour long) and trying to get an appointment with a local doctor for them. T0 be yelled at, and berated and BLAMED for their problem which we gave them multiple avenues to solve.. what did we get?? A kick in the proverbial nuts.

Prexige (lumiracoxib)… released not all that long ago, has already been withdrawn from the Canadian market. I read the Health Canada warning about it, but since I am not in the position to make judgements, I can simply say, the company issued recall that we got said “not due to safety concerns–quality issue”. The recall issued by Health Canada says it has withdrawn market authorization.

The decision to withdraw market authorization for Prexige follows a review of additional safety information submitted by the drug manufacturer, Novartis Pharmaceuticals Canada Inc. The information was requested after Prexige was removed from the Australian market in August 2007, following reports of serious liver adverse events that were linked to the drug at doses of 200 mg and 400 mg daily. The experience of other international regulators is a potential source of safety signals for new drugs when the Canadian real world safety information is limited.

As a result of its review, Health Canada has concluded that the risk of serious liver-related adverse events with Prexige cannot be safely and effectively managed at the 100 mg daily dose.

I wonder if the pharmaceutical companies are releasing these medications far too quickly to accurately judge whether or not they are safe. This is the third Cox-2 inhibitor that has been withdrawn…along with Vioxx (rofecoxib) and Bextra (valdecoxib). Celebrex (celecoxib) has recently been changed from a drug that is freely covered by most drug plans, to a special authorization medication because of higher incidents of heart related issues. Do the benefits of this class of drug outweigh the contras?? As one who doesn’t suffer any type of joint pain…and a technician without the full knowledge of how the drugs work, I couldn’t say.

On a side note..we have all heard the sayings “for every doctor there is a pharmacist out there who saves his ass” and “for every pharmacist there is a tech who saves his ass”…. I was that tech today. We had an rx brought in today for levaquin 1QID X40. A pharmacist typed up the rx. I went to count it and said “WHOA!! Levaquin four times a day??? That’s not normal!! Can they do that??” to which a second pharmacist replied” I’ll call the doctor back.” Sure as shootin’, the doc wanted once a day dosing for 10 days. I think if I hadn’t caught it and counted out 40 and moved it down the line (back to the same pharmacist who had typed it up) and let them check it.. the patient would have walked out the door with the wrong amount of medication (and a HUGE bill to boot). I saved a few asses today. <pats self on back>