Pissing into the wind of medicine

This is all made up.  Uh huh.  Its a bit of a hard read to protect the identity of the stupid er.. the made up stupid… Uh huh.

It was your usual day at the Angry Pharmacy.

I got a call from a resident that I’m on fairly good terms with.  She wanted to increase the dose on a patient diabetes meds.  She wondered why the patients A1C was climbing lab after lab and thought the medication wasn’t working.

I pulled the patients profile up.

Month supply filled Jan and March.  Something wasn’t right here.  Maybe he/she was going to another store? Only one way to be sure.

I told the resident to ask the patient to bring in all of his/her meds in so I could “take a look at them”, which in pharmacy speak means “See if you are fucking taking them”.

Patient comes in with a plastic bag full of pill bottles (oh dont we just fucking LOVE it when they do that) and a new Rx.

Every single bottle of maintenance med was full.  EVERY FUCKING ONE OF THEM.  It had more fucking diabetes medication than I did on my shelf in that one plastic bag.  Most were from us, some were from a different pharmacy dating back almost a year, all were filled exactly on time.  This looked like two big scoops of not-fucking-good.  In fact, the refilling gaps in MY system were accounted for by another store’s filling.  This required a “come to Jesus meeting” by yours truly.

I asked the patient, who had almost every risk factor for diabetes in the book, why it wasn’t taking the medications.  Then the bomb was dropped.

“I know my body, and I know what its doing, I dont need this shit.  I just need my pain pills”.  Hear that needle being pulled off of the record of medicine?

Now its A1C would score a solid gold in the A1C Olympics.  I could use his/her urine to compound in place of simple syrup.  If it wasn’t the copious amounts of bullshit flowing through its veins I’m sure they would of died by now.  I asked the pushy patient if the doctor knows its not taking its medication.

“No, if I told her that, she wouldn’t give me my pain pills”.

I wanted to punch him/her in the face.  I asked if he/she had side effects, or any reason why he/she didn’t want to take the medications.  Sometimes the twice a day is too much for people, there are options that I could suggest.  This resident was an awesome one who loved pharmacists thanks to yours truly (you’re welcome) and would do whatever I suggested.  Look at me! Being all pharmacist like!

“I told you, I know my body, I dont need these, I’m fine.”  I fucking love it when they use that line.

Nothing I could say could make his/her take them.  Threats of blown out kidneys, to losing his/her sight, to not having legs, nada.  So.. Fucking.. Frustrating…  I tried to play the pain card, saying that her pain could be because of damage to nerves.  “Gabapentin doesn’t fucking work on me, neither does Vico-dan.  I need Percocet”.  This was said with a straight face as I could line the entire pharmacy an inch deep in unused gabapentin caps.  I offered to work with the patient and the doctor to help her.  I even offered to fucking blister pack the medication to improve comp-LIE-ance.  Nothing would work.  The patient had either given up, had a fucking stroke and got incredibly dumb or just really wanted to get high.  Maybe if I printed “HAVE YOU TAKEN YOUR MEDICATION TODAY” on a package of cigs or a lotto ticket it would make a difference.

The conversation turned into the “I dont want to talk with you anymore.  How long until my Percs are done” song and dance when I called it on bullshitting the doctor to get more narcotics.  Sometimes it takes being an asshole to get the point made.  My preceptor used to tell me, “TAP, never argue with an idiot, they will drag you down to their level and beat you with experience”.  If I followed that advice, I wouldn’t have any patients.  I knew that short of a diabetic complication 2×4 across its face, there was nothing I could do.

Then the blood started to boil.

This person gets FREE care and FREE medications.  It isn’t out anything but his/her own time to take care of her condition that could leave her legless, blind, and on dialysis.  Of course all care related to stupidity would be happily covered by the state.  None of that mattered to him/her.  90% of the working population would KILL to have what he/she is getting for no cost.

You know when I ranted before about how a person places no value on something that they aren’t paying for? Case in point, right in fucking front of me.

Now this person is spending, nay wasting, hundreds of taxpayer dollars a month that could be used towards someone who actually gives a shit about their health, about their care, about their body.  A person who could actually get a better quality of life while they get their life back on track.  If this douchebag wanted to just get fucking high and watch his/her health spiral down the shitter, thats great – just don’t take the resources that could be used to help someone who gives a shit.

So the question remains: at what point do we, the healthcare people, decide to cut-bait on a patient that obviously doesn’t give a shit about his/her health and is only seeing you because they are being forced to (or to get narcotics)?

Oh, and I paged the resident (I REALLY hate paging doctors, but I figured this was important) and let her know what was going on.  After a bunch of “are you fucking kidding me” she requested the patient go back to her for “clarification” on the percocet prescription.  I think someone is going to get a type-1 ass-chewing, but something makes me think its not going to make much of a difference.

I love making shit up *ahem* to prove a point.

Angry Tweets for 2011-06-05

  • Doing dishes suck. #
  • And my angry forums are… dead. Sorta glad I didnt pay 200 bucks for the software (though they have been up > 24 hours) #
  • Oh, and you need to sign up/login to get to the ranty part of the forums, google-bot insurance to prevent ppl from getting busted. #
  • And by the forums being dead, i mean nobody is posting to them, and they have been up < 24 hours. I suck today. #
  • Fuuuuuck. Converting toliet to dual-flush required unauthorized use of dremel tool and fucking testosterone #

Angry Tweets for 2011-06-04

  • Today is going to suck. #
  • Yeah, its #penisfriday alright, both ends of the pharmacy dildo you-know-where. #
  • Trying to look busy so I dont need to talk to a drug rep. On a friday.. The first part of the month.. At opening. #
  • Seriously? You're getting $400/month in drugs for FREE and you're bitching because you have to come here EVERY MONTH (omfg lazyfuck). #
  • Watching horny old nasty patients flirt with my clerks is like watching old people fuck, amusing yet horribly sad. #
  • This week has brought me an incredible offer that I had to regretfully refuse. 🙁 #
  • Ugh, so many talkatave crackheads that are all obnoxious because their Percocet Rx is in the process of being filled. #
  • Im always happy to take time to teach something to a resident, but it pisses me off when they refuse to learn. #
  • If you let your resident-MD ego get in the way of learning something from a lowly pharmacist, you are going to have a miserable time in life #
  • "All that needs is a slap and a little bit of lube" #outofcontextpharmacyconversation #
  • "Her parents are both batshit crazy, that makes her damn good fuckin! Crazy in head = Crazy in bed" #outofcontextpharmacyquotes #
  • "Cialis fixes boners, it cant cure ugly" #outofcontextpharmacyquotes #
  • "MY NAME IS DILANTIN! I stop people from dancing :(" #RxGabbaGabba #
  • I really want to sell Narcan crystals on the street as heroin. Does that make me a bad person? #
  • Oh god, finally home! #
  • The Angry Forums (beta) are open for signups http://www.theangrypharmacist.com/forum Still in the process of working on it. #

Angry Tweets for 2011-06-03

  • Off to work, FML, it was nice knowing all of you. #
  • "I dont want the round methadone, I want the other kind". How about you get no fucking methadone. #
  • "The round ones dont work for me". Well your fucking shitty crackhead personality doesn't work for me either. #
  • Prince is on the radio, if BKBJ sings im killing him. #
  • Lantus ok x 6 but needs appt for syringes? Are you giving this guy diabetic blue balls? #
  • WARNING! TOBACCO IS ADDICTIVE! (well so is porn, eating, watching tv, lazyness, twitter, the internet, etc) #
  • Maybe a kick in the balls will give this resident a reason for writing like absolute messy shit. #
  • Shit, I really want a steak now. Thanks @DrJonathan 🙁 #
  • Wow, this resident is the undisputed king of polypharmacy.. You dont need to Rx the whole PDR son. #
  • Dear Resident, get your ducks in a row if you decide to blast me on drugs, I think a whole lot faster than you do. #
  • dicked by doctors, dicked by patients, dicked by insurance companies, dicked by dickhead drug companies. #

Angry Tweets for 2011-06-02

  • If I get one more ER Rx for Debrox i'm going to go on a fucking rampage. Seriously? ER for earwax? Why not go to have your ass wiped. #
  • Oh, debrox and claritin this time. BRB, raging. #
  • I renounce the hashtag #hcsm because i'm just a fucking pharmacist who isn't subject to pole-up-ass rules and bullshit. #
  • Hey Pt, you know I told you last month the MD said you needed an appt before next fill? Yeah, you're sadfaced now. Should of listened. #
  • You want trade name, yet you dont want to PAY for trade name. Life doesn't work that way idiot. #
  • I need an intern to absolutely ruin upon. #
  • Cant control one kid so you decide to squeeze out a few more? Tell me where that makes sense. #
  • My boss just said "boy! You're cranky today!" #
  • Hm, sorry Aldara is so expensive. Check the runway before you land your plane next time. #
  • MD office fax back: Gauge for insulin syringes? My response: .410 for doves, 12 for anything larger. I bet they wont get it. #
  • Oh god today sucked. #
  • If pharmacy is a dildo, I just got the 18" black double ended one. #
  • I seriously just sat on my nuts and hurt them. #
  • no, i dont have a hydrocele thnx. #

Angry Tweets for 2011-06-01

  • Did @mommy_doctor delete her twitter? #
  • To @mommy_doctor – We know why you left, we dont like it, and we'll miss you. #
  • All I need is your name, DOB and Rx numbers. All the other blah blah shit out of your mouth is just that. #
  • Big thanks to the kind patients who dont act like dicks in the store. #
  • What the fuck! Why the hell is @BurbDoc above me on cursebird.com. This is fucking bullshit! #
  • My coverage expired, but I dont want to pay for it. OH SHURE WHY NOT! Fucking people. #
  • OMFG – @TheAngryBKBJ (to me): Im so into you. Me: *blank look of shock* Him: You ever wish you could take back something you just said? #
  • Me: "You mean like offering you a job? Yes". #
  • Rnd2 – @TheAngryBKBJ: "Why do all the faggity guys get laid by all the hot chicks" Me: "Ask that question in the mirror". #
  • If @TheShyPharmD can get more followers than APhA (@pharmacists) by her showing boobs vs them doing something for pharmacy, thats pretty sad #
  • Considering i have 4.7 times more followers than APhA, that says something about who the voice of pharmacy is in the US. #
  • "Anusol-HC is like vicodin for your asshole" <– OMFG HAHAHAHAHAHA #
  • Fuck, why does Gabapentin cost so fucking much now? #
  • I miss @mommy_doctor. Anesthesiology is the closest thing us pharmacists have with specialists. #
  • hahaha I love medical twitter people. #