Category Archives: Hate Mail

The big welfare mother rant.

This one is going to be a doozy, so please read the entire post before writing me a 10 page comment about your life story and how much of an asshole I am.  If you still wish to write me a 10 page comment on how society forced you to get knocked up while on welfare, then I’ll give you a story how society FORCED ME to use rough 2-ply toilet paper to wipe my ass instead of the good soft stuff.

Oh, and for the record, “welfare” here means full blown don’t-have-to-work-all-inclusive aid.  I’m not going to pick apart food-stamps but not free-housing or check, etc.  I say government ticket, I mean the entire government ticket.

This is how I see the welfare system working:

Girl “falls in love” at the ripe age of 16, and through the magic of laziness, hormones, stupidity, and complete irresponsibility allows herself to get pregnant by some loser.  The loser, taking  parenting advice from rap stars and TV idols, leaves that bitch and moves on (“hey, don’t hate the playa, hate the game”).  The mother, now single and with child, goes on the system to get assistance until she can finish school and get a job.  At which point she gets off of the system and pulls herself up by her bootstraps and becomes a model mother and a productive member of society.

That above I have no problem paying for.  Hell, believe it or not, that’s what the system was intended for!  However this is what mostly will happen:

Girl above, when her child is 2 years old, finds another douchebag reject and through the magic of not-fucking-learning-the-first-time gets pregnant AGAIN.  Repeat about 4 more times.  Kids run out of control and tear my shelves apart, and she bitches at me because the Septra suspension for kid #5 is grape flavored and not cherry.

Let it be known herein and throughout the tubes of the Internet.  If you are already on welfare, and you get pregnant again (ie: you already are established on the system and you spread your legs and accept seed again), you are the most irresponsible, stupid, waste of human skin on the planet.  You are nothing more than a receptacle for some dude to keep his sausage warm and serve no use to us other than to leech away our money like a tick on the ass-end of society.  Go and make porn flicks because your only mental and physical skill in life involves your mouth and between your legs.

It blows my mind how absolutely stupid someone can be to be on welfare (you know, implied that you cannot take care of yourself so the state has to take care of you) and bring another child into this world.  Getting pregnant once is a freebie in my book, shit happens (though barely now that Plan-B is OTC). The second time however is 100% you’re-a-fucking-moron.  The third one on is what-the-fuck-were-you-thinking (oh, you werent).  Birth control is FREE! It just takes a bit of effort (ie: getting off of your ass) to get!   Have they gotten the memo that welfare is not intended for living off of for your entire life?  Did it ever occur to them that if the welfare system suddenly says “Uh, no more money for checks, so sorry!” they are completely and utterly fucked?  Ugh, so retarded and so stupid.

Lets compare 2 irresponsible acts:

  • Spending your check on spinning rims instead of job-interview clothes: IRRESPONSIBLE
  • Bringing another human-being into this world when you are 100% reliant on the state to wipe your ass currently: REALLY-FUCKING-IRRESPONSIBLE

Usually if you cannot afford something; car, boat, whatever; it gets repo’d.  YOU CANNOT DO THAT WITH A CHILD!  Pregnancy isn’t some magical unknown event that just “happens”.  Its as preventable as avoiding getting your car stolen by LOCKING IT, or avoiding wrecking your car by NOT RUNNING INTO WALLS.  Which means that the only way these career welfare mothers are getting pregnant is out of sheer laziness and stupidity.  Surprise surprise!  Close your legs until you can afford to open them!

My solution, and one offered by other readers on here, is every 3 months, when you get your welfare paperwork reevaluated, you get a shot of Depot Provera.  I don’t give a rats ass about side-effects, these people are already on the downward slide, so we’re doing damage control now.  You want your check, you get your depot shot.  You don’t want your birth control shot? Then I guess you get no check!  The state pays for your life, the state gets to make the rules.  In “real life” if my boss asks me to clean the toilets, then I clean the toilets.  Know why? Because my job pays for my life, so my job gets to make the rules.  I realize that the “job” part is a foreign concept, but just trust me on this one.

I know I’m going to get at least one comment by some idiot saying that “reproduction is a right”.  Well, to them I say “Leave your gated community in your $60k SUV once in a while and open your fucking eyes.  If they have a right to reproduce like fucking rabbits, then I have a right to not pay a fucking dime towards the product of their irresponsibility.”   Seriously! Fuck and reproduce all you want, but don’t come to Uncle Sam asking for a double fist of government cheese.

So, I challenge you all to give me ONE DECENT point that refutes my belief that the woman who is on welfare and gets pregnant yet again is the most irresponsible person on the planet.

For your enjoyment (and since we’re talking about the pinnacle of irresponsibility), here is Octomom in a blender:



Really good rant on the subject at Violent Acres

A Clinical Pharmacist Error.

Once in a while I get a rather bitter comment from a “Pharmacist” who just got his shiny new degree and license and thinks he knows it all.  Now I was going to let you (the readers) be ‘The Angry Pharmacist’ for the day and give this guy a new ass-chewing, but I figured that I cant let this comedy gold go untouched.

Well, I think you were a little too harsh on the intern. I have been a
pharmacist for 3 years and if you had called and asked me to give a
copy, i wouldn’t have had a clue what you were talking about. The
funny thing is that, I still don’t know what you mean by giving a copy.
If you mean to give a transfer, i can understand that.

A few hints for the next time you put your clinical foot in your clinical mouth, don’t tell people how long you’ve been out of school (unless its like over 15) ESPECIALLY when responding to a rant about something you SHOULD OF LEARNED IN SCHOOL (did you even read my rant?).  Plus the fact that you cant put transfer/copy together is just shooting yourself in the foot.

I am typically a clincal pharmacist and i work in the ICU and emergency room setting and
so may not be familiar with all the details regarding a retail store or
how the insurance is run and all that extra things. I have filled in a
retail store before and yes I was lost but I don’t consider myself dumb
because of that.

So why in the fuck are you responding to this rant?  Oh, you’re a clinical guy who probably talks just to hear himself sound intelligent.  You responded to a rant about the lack of core retail pharmacy skills being taught in school by saying that you don’t work in retail.  Tell me if that makes any fucking sense what so ever?

I don’t think the intern was dumb because she or he
didn’t know what the term is, maybe he or she is used to a different
term. As much as I hate to say this, the dumbest pharmacist I’ve seen
in my life are the retail pharmacist.

You know that feeling that you would get when you see a retarded toddler run out into the middle of traffic after a ball? Yeah, I just got that feeling right now.  Its the feeling of pity, horror, but morbid amusement as to how this is going to resolve itself.

I hate to use the word dumb
because, I think it’s very inapporopriate and disrespectful. I think
it’s just a different forte.

Then why in the fuck are you responding if you know nothing about retail?

Most of them have no concept of the
pharmacology, basic clinical knowledge, disease states and
pharmacokinetics (a bit surprise you think it’s dumb). Giving a copy
will not save someone’s life, anyone off the street could probably give
a copy, kinetics saves a lot of lives everyday if you really and trully
understand it.

You’re right, us retail folk are all clinical dropouts who couldn’t cut it in the ‘labcoat lunches with the doctors’.  In fact, why aren’t all pharmacist just dropouts who couldn’t cut it in medical school so we had to ‘settle’ for pharmacy?  You’re a fucking idiot.  You are a huge fucking idiot.  You are one of those idiots who can recite the kinetic data for anything but can’t hold a fucking conversation with anyone to save your life.  You know what kills most people? Clinical pharmacists with huge fucking egos who fuck up, thats who.

I also want to mention that this is a free country,
foreigners are welcome here and we should not make fun of the way they
talk. Some of my best pharmacy professors were foreigners. As much as I
think it’s funny the way they talk, I don’t take it upon myself to make
a spectacle of them. I think you are very immature and should not be
practising pharmacy.

Yeah, they are welcome here, I’m not saying they shouldn’t.  However I should have the expectation to have clear and easy to understand English being said to me when dealing with people’s lives and medication.  So tell me Mr Clinical Guy, would you rather offend someone or kill someone because you guessed what the person was saying.  I don’t make a spectacle of them, I tell them that I CANT UNDERSTAND A FUCKING WORD THEY ARE SAYING.  Let me take your mother’s medication over the phone by someone who can’t speak a clear word of English and see how you like that.

You have forgotten that you were once an intern
and there is still a lot of things you don’t know. I have retail
pharmacists that switch to hospital work and have not a clue what’s
going on. I calm them down and try to re-assure them that it will get
easier and that everything will be fine and that’s exactly what you
should be doing.. I have a retail pharmacist once try to enter an order
for 40mEq of potassium IV push, another entered an order for cefepime
and rocephin and zosyn for treatment of psuedomonas. these things are
pretty basic knowledge but it honestly did not cross my mind to call
the pharmacist dumb because I know it’s hard concept to grab if you’re
not used to doing all that. A doctor once asked if vanco would cover
for bacteroides fragilis and one the new retail pharmacist said “I
think so”. Well, bacteroides is an anaerobic bacteria, completely wrong
answer.  If everyone of us treated interns like you do, then we will
have no interns or no one will want to get into the profession of
pharmacy. You sound like one of these jackass arrogant surgeons at the
hospital, that knows nothing about drugs but thinks they are the alpha
and omega.

 Well don’t you get the Nobel peace prize for being the most compassionate and understanding pharmacist on the planet. Wait, did you realize what site you are on?  Did your huge clinical knowledge of kinetic data tell you that you are on THE ANGRY PHARMACIST site?  Guess not.  Maybe its like the copy-transfer thing.  If I made the site THE MAD PHARMACIST or THE MEAN PHARMACIST would you understand?

I know my fellow readers are going to rip you a new asshole for being such a douche, but seriously, your little comment was probably the most embarrassing thing I have ever read.

Fixed Income Medicare Blues

I know I haven’t been posting lately compared to my DrugMonkey and Angriest counterparts.  Don’t feel like getting into politics here and I dont like to rehash stuff (too much).  Had to reprime the angry-reserves. 🙂

People always sing to me the ‘I’m on a fixed income” blues when they are paying their Medicare Part-D $3.10 copays for their $200 Nexium Rx.  Oh, how soon these idiots forget what life was like before Medicare Part-D took effect.  Did they somehow forget paying full price out of pocket for their medications?  Why is now $3.10 so much of a financial drain on their “fixed income” when just 4 years ago they were paying 10x that amount with a smile on their face.  I really do get a huge hard-on when I bring up how much they were paying before Part-D and how they are only paying $3.10 (which makes them feel like huge ungrateful douches).

Medicare Part D has spoiled seniors, plain and simple.  They are so hung up on their “fixed income” that they have completely lost sight that the people who are footing the bill for their expensive medications are the same people who will never ever see a dime of the money that they contributed to the system.  They also fail to see how Medicare is pretty much socialized medicine for people over 65, and we can see how well THATS going.  Medicare recipients complaining how we should have socialized medicine in this country just makes my irony meter fly off of the chart.

What do you expect from old people other than cow eyes, the same question asked every week, and bitching about $3.10 copays.

Paging Dr Dave… Your douche is ready..

Out of your options for refusing to help with the current (non)
cutbacks (see, that is what a court order does genius, STOPS something
from being implemented, hence NO 10% cut….oh, skip trying to explain
THIS to a pharmacist) I must take option 3 below.

Genius? Me? Did you even read the first paragraph of that last entry? You know, the one that I said “However, last Saturday the courts overturned the ruling until 8/11/08. Their computer systems still have the 10% cut, but they will let us know how they wish to deal with that ball of wax once the shit stops falling from the sky in the legal department.”
Update: Got the fax yesterday saying that the 10% cuts are here to stay. The injunction was injuncted upon by yet another injunction reversing the injunction-junction (whats your function). Yeah, I cant believe it either. This is really going to suck.

1. Lazy
2. A dick
3. Think so little of us that you don’t give two shakes of a mouses
dick what happens to us.
4. Have some ill-gotten god-complex that fell out of fad about 20 years
ago when managed care/insurance companies snipped off your scroatum and
dangled it in front of your face while saying ‘HAW HAW’
4. All of the above
Since most pharmacists I have to deal with here are 1, 2, 4 and (the
other) 4 (with THAT counting ability can you wonder why I doubt the
competence of most people in your business? 5 comes after 4 genius!). I
really think 3 is my own position. Sorry you won’t get a 150% markup on
your generics for a while, but in case you didn’t notice, the Feds
tried to do the exact same thing to us, and it fell through too. The
10% cut will also die on the vine thanks to the court order.

Yeah, I did put 4 twice. Sorry, my mistake. Thanks for pointing that out to me in the most asshole way possible. I originally had 4 be “all of the above”, but then I decided to add something in about the god-complexes that you oh-so-quaintly have shown everyone still exists.

Unless the PHARMACISTS start lobbying. When they are through WE will
have to pay the State….

Uh, we’re lobbing the hell out of the state. However lobbying does only so much when the state is 1000 trillion dollars is debt.

Here is my own quiz, based on the previous model:
Most, but not all pharmacists are:
1. Lazy
2. A dick
3. Think so little of everyone BUT themselves that they don’t give two
shakes of a mouses dick what happens to us.
4. Have some ill-gotten god-complex that fell out of fad about 20 years
ago when managed care/insurance companies snipped off your scrotum and
dangled it in front of your face while saying ‘HAW HAW’
4 (which SHOULD be 5 – leave it to a pharmacist). All of the above

Thats cute, just copy and paste what I wrote. I can see now how you got through medical school.
— Round 2 —

I am NOT a chronic pain patient, I am a practicing physician and I am
absolutely sick and tired of idiot pharmacists having a bad day calling
me to tell me what I fucked up on my scripts.

Then don’t fuck up on your scripts 🙂 Seriously, do you think we want to sit there and waste our time calling your obviously unhappy soul to tell you what you messed up on? Do you think it gets us off to be yelled at by some doctor who obviously takes his frustrations out on his office staff and the pharmacist who calls to save his ass? No.

If I wrote a particular
treatment prescription I did it for a reason. Please don’t argue with
me as you attempt to be so many amateur physicians. I realize that you
went to 5 years of school to learn pharmacology, and I respect that.
What I can NOT stand is that fact that none of you seem to respect that
I and my colleagues went to school for 10-12 years and, whether you
want to hear it or admit it, know a fuck of a lot more about medicine
and pharmacology, and more importantly how they interact and will
effect OUR patients than most of the arrogant, self absorbed, insecure
pharmacists that call to tell me I can’t prescribe A with B.

See, the fact of the matter is that if we just “fill the prescription” and the patient dies due to your arrogance and stupidity, then we are at fault just as you are. However if we call and you make our requests known (and obviously document it), then when your arrogance and “10-12 years of school” kills someone (or lands them into the hospital), we don’t get hauled into court. Well, I take that back, we do get hauled into court, and there is no doubt that you would lie and say that you didn’t talk with us about our concerns.
Now due to the condescending asshole tone of this email, I have no doubt in my mind that if we are sitting both in court, the very first thing you would do is point at me and said “THE PHARMACIST SHOULD OF CAUGHT THE MISTAKE” (even though you bitch here that we bug you too much).

Shut up
and fill the fucking scripts unless you are damn sure there is a
mistake. As I get at least two dozen calls a day between “corrective”
calls about my prescribing and suspicions about my patients that I
prescribe anything stronger than Ibuprofen, it gets ridiculous.
Pharm D? THAT is a fucking joke!

Two dozen calls a day? Okay, either this figure is way out of line, or you are prescribing some really shady shit to some shady people. “Just fill the fucking script” doesn’t quite work if the patient received 100 norco from another pharmacy yesterday.
You see Dr Dave, this whole situation really smells fishy. Most pain management clinics really have no problems with pharmacists and pharmacists don’t have a problem with them UNLESS a huge red flag comes up. If “two dozen” pharmacists are calling you about your “prescribing and suspicions” about your patients then obviously you aren’t just giving out Amioderone to a patient on Warfarin (which your ****10 YEARS OF SCHOOLING!@!@#!@$**** should tell you why that one is a biggie). So tell us Dr Dave, how many gallons of Norco do you write out on a daily basis to have all the pharmacists on alert? Have your Rx’s (and patients) been booted out of every pharmacist in town? Is that why you are so hateful?
You see, part of being a pharmacist is that you get good at sifting through the bullshit.

Here we go again…

I posted the below comment on Dr. Dino’s blog. You can choose to
publish it or silently agree:
“Good on you Dino! Pharmacists are glorified cashiers that get a sense
of satisfaction because they feel they are ‘saving lives’ from poorly
or ineptly written scripts from MDs.
P L E A S E pharmacists, stop using this bullshit excuse that you are
saving lives!!!
Keep on Dr. Dino. Remember, your work and status as a physician is
respected; pharmacists have cashier-level status and zero respect. (as
it should be)”

You know, you’re right. We dont save lives. When that GP writes an Rx for Viagra when his cardiologist has him on Isordil we aren’t in fact saving his life. Drug interactions are just a “made up” thing by the drug companies to sell more of the same type of drug. Glad you decided to blow the whistle, I was actually having a hard time hiding the fact that I just stand there and drink coffee while counting by 5’s all day.
I bet you think that nurses are just glorified janitors who clean up shit and piss for a living. Nurses don’t save lives either. Hell, I dont even know doctors who save lives because when lives are truly in danger people just take a ride to the local hospital.
I hope that you never have to rely on us lowly pharmacists to serve someone as smart and obviously well informed as yourself.
Obviously the person who left this comment was pissed off that he/she couldn’t get a refill of Vicodin ES 3-weeks early by the evil mean cashier pharmacist.

Political correctness, terminology, and being retarded

I recieved a comment recently from a fan (although I’m not sure if they will still be one after they read this) that took exception to my use of the word “retard” to describe some of the people I deal with on a daily basis.

Short Answer: Deal with it, I’m using retard.  Sorry that you are offended by it.  The site is the ANGRY pharmacist.  If you want political correctness this is not the place to go.  I’m not going to censor or take into consideration the 2% of the population that I might offend using the word ‘Retard’ on a site that is dedicated to venting about the public.  Even then, they themselves probably would not take offense, but people who want to be offended for them.

Long Answer: 
Being all gushy and PC about stuff like this really bugs the hell out of me, so I decided to make a rant about it.  There are a bunch of people who want the word “Retarded” stricken from the English language as a reference to someone who is diagnosed with Mental RETARDation (because the two obviously arent related).  They want to be called “Learners with Exceptionalities” or “Mentally Challenged”.  Yeah, lets call cancer “Abnormal Tissue Growth” – AIDS “Immunology Challenged” and schitzophrenia “Socially Unacceptable Thought Processes”  so we might not offend the people with that either. 

The world is not going to cater and wrap everything in foam and bubble-wrap for you.  Dont try to candy-coat something that is a serious issue.  Mental Retardation is not something that you can just put fancy/huggy words to make it “less offensive” and have it magically be somehow “better”.  I would be MORE insulted by people trying to side-step my condition rather than just call it what it is.  Just say what it is rather than trying not to offend me by blowing smoke up my ass.  A duck is a fucking duck, not some huggy words that I cant think of right now that would describe a duck.  Which brings me to my next point.

Just because I use a word on here does NOT mean that I’m using it in reference to a particular person, class of people, or your crazy uncle (whoops, i meant mentally abnormal uncle).  Nor does it mean that I am putting down a certain class of people.  You would think that some common sense would be implied here since you are reading this from a site called ‘The ANGRY Pharmacist’, but some people would be surprised to see naked boobs and cock on site called ‘HOT TEENS EAT BUTTHOLE’.

In closing, I’m sorry that you were offended, and as someone who (for a living) puts more medication into blister packs for people who are diagnosed with Mental RETARDation than you can shake a stick at (and also sorts them out when they punch out ALL the pills) you can rest soundly knowing that I think political correct terms for things are retarded.  Hey, at least they aren’t called Invalid’s anymore.

Here is a really good post on the issue I found on the LiveJournals.  You can find the original here:

There’s a reason you aren’t offended: because people who are offended by humour suck.

I’ve said this before and I’ll say it again: when someone tells a joke
that’s potentially offensive and you laugh, you’re either laughing at
the humour (the timing, the unexpected punchline, the fact that it’s
taboo) or the content (rape, murder, racism, sexism, etc.)

me, I assume people are laughing at the humour and not laughing at the
content. Why? Because there’s nothing genuinely funny about any of the
content. Racism itself isn’t funny, but racist jokes can be–and
people’s indignant reactions to them even more so.

However, when
someone draws a line–that is to say, when someone has a “sacred cow”,
like “racist jokes are funny but jokes about rape aren’t”, then I have
to assume that they’re not laughing at the humour. Otherwise, they’d
realise that both are funny. That leaves me with the intolerable belief
that they’re laughing at the content of the racist jokes.

minute you draw a line or decide that some subjects are just not
appropriate for humour, you’re saying that subject is somehow more
important than all the stuff you laughed at. It’s a definite implied
value judgment–AIDS jokes aren’t funny because AIDS is serious, but
jokes about rape are funny because rape somehow doesn’t matter.
Moreover, you’re saying that racist jokes are funny because racism is
funny, etc. These are not the sort of people I care to share a laugh

It’s the same philosophy Trey Parker and Matt Stone
follow. They’ve said over and over again with South Park that the
minute they decide something is off limits, then everything else
they’ve ever done becomes offensive.

In other words, be proud
and happy that you don’t have a “sensitive” issue. It means you’re not
a fucktard. Part of the reason I try to offend the offendable is that I
hope some day they’ll learn this lesson and join us on the side of
humour for humour’s sake.

Sore loser. Boo Hoo.

Look at the comment I got to my victory post:

I hope your happy. You’ve ruined my life — you lifeless, soulless,
waste of flesh. I just received a call from my District Manager —
today was my last day. The found cached copies of my site on Google
even though I completely took it down. There were no HIPAA Violations,
but they are firing my for conduct unbecoming-of-a-pharmacist. I also
have the pleasure of repaying my sign-on bonus…Ten Thousand Dollars.
I’m sure I’m now blacklisted from every other major pharmacy chain
thanks to your little letter writing campaign.
I also hate you for taking my blog from me. It was mine – my
intellectual property. All I did was take a simple idea and made it
better — 100 times better.
Your blog sucks. Your life sucks. May you develop erectile dysfunction
after marrying out of your league.
Just so you know, I’m going to appeal this with a real court/lawyer and
not those idiot assholes at ICANN. I’ll see your ass in federal court.
Now that the world knows who I am, we’ll see if we can’t find out who’s
behind your mask.
Die a slow and painful death,
The ANGRIEST Pharmacist

Have some cheese for your whine. Maybe next time you can start a website named ‘moogle’ or ‘pharmcrosoft’ and play the pity card when they smack you down like I did.

Oh jeezus, I pissed off the diabetics now.

Ah look, the diabetics come out of the woodwork. WATCH OUT, I HAVE CANDY AND I’M NOT AFRAID TO USE IT! I would like to point out that below I refer to diabetes as a ‘condition’ and not a ‘disease’. See, those PC/sensitivity classes are paying off. 🙂
On the other hand, when I piss people off they come to the site to whine, read past entries which makes them laugh, then they keep on coming back. Just ask The *Angriest* Pharmacist (or is his case, copy me) :).

As a pharmacist it is none of your business haw many strips a patient
uses. Strips in no way can hurt a patient and one can not overdose by
using too many. If a doctor writes a prescription for an unsafe dosage
of a medication then the pharmacist is correct in questioning the
order, however this is not the case. As far the insurance company, one
should ask, are working for the insurance? are you the insurance
police? who made you in charge of determining how many times a diabetic
can test? I think you should go about your business of filling
prescriptions and leave the ordering to the doctor, and not worry about
how many strips the insurance company should allow.
Interestingly, if a person goes into a drug store and purchases 100
bottles of strips each month and pays cash for them you wouldn’t ask
those questions. You would be thankful for the business, but because
insurance is involved you feel you have a duty to limit the amount of
strips uses.

Woah, wait a second. You’re telling me that its not my business to deal with how many strips a patient uses for a condition that I fill Rx’s for? Since you obviously have no idea what goes on in a pharmacy, let me enlighten you. Every Rx you fill has a day-supply associated with it. If 50 test strips lasts you 10 days (and you aren’t on insulin), the insurance company is going to come to ME and want ME to submit documentation to justify a type-2 diabetic (who cannot control the dosage of his medication) testing 5 times a day. Do I have any? No. There goes 50 bucks from my next reimbursement check. Simple as that. If you want to pay cash for your strips thats fine, but if you want the insurance to pay for your strips then we all have to play by their rules, you dont like it then pay out of pocket for your strips. You want someone to pay for your life then deal with it.

Where in heaven’s name did you go to Pharmacy School? Didn’t they
teach you that a non insulin-dependent diabetic also needs to know how
their diet and stress are affecting them?
Every bite they put in their mouth will raise the blood sugar. To
avoid the complications of diabetes (yes, all diabetics are susceptible
to them, insulin-dependent or not) these people must know exactly where
their blood sugar level is at all times.
Another factor that can cause the blood sugar to rise is stress. When
the liver senses release of stress hormones, it releases sugar into the
bloodstream to fuel energy for the “fight or flight” response.
All of these things must be learned and then checked and rechecked.
Can you imagine someone wanting to make themselves bleed for the fun of
it? Being a diabetic is no fun, especially with people like yourselves
imagining how simple it all is.
Shame on you.

Yeah, thats great, the patient knows that eating a ton of candy raises their sugar into the 400’s. Thats maybe 2 or 3 tests at the absolute most to confirm that. What can they do about it? They can’t adjust their medications to compensate for this so why bother testing. If you eat something and it boosts your sugar sky-high twice, then obviously you know what NOT to eat. Is there justification for testing 5 or 6 times a day everyday for months upon months for something that you have NO control over? I mean how many months does it take for someone to learn what they CAN and CANNOT eat. After 6 months of trial and error of what works and does not work what excuse do you really have to test that often?
You say that they must know exactly where their blood sugar is at all times. Yeah, thats great, if they are insulin and can do something about it. What are you saying? That they should skip meals if their blood sugar is through the roof? Thats not healthy either. “Oh look, I ate birthday cake and my sugar is up to 400, guess I can do nothing about it since I already took my 2 glyburide bid and 1 metformin bid today.” At least the folks on insulin can compensate, oral meds not so much. Lets look at the gas gauge every 3 miles but not stop for gas when we’re at empty. Oh, and lets throw away $1 every time we look.
Oh, and guess who gets to suffer if the payer of your test-strips doesn’t like how much you are testing. Its me. Not you, but me. If you want to test 100 times a day and pay cash for your test strips, thats fine, more power to you. However when insurance companies are paying the bill then YOU need to abide by what rules they set up, and trying to get doctors to provide justification for a type-2 diabetic who burns through 5 strips a day for 9 months and is noncompliant as fuck on their medication isn’t my idea of a good time. In fact, it has cost me on more than one occation a filling or 20. Do the math at a little over $1 a test and tell me why i’m a bit pissed. Plus this puts me into a bind. The “diabetic” (I use that term loosely since they obviously don’t take any initiative in their care) needs their strips, but there is a good chance that the insurance company wont cover it. The patient can’t afford $100/month in test strips. Do I chance it and cost the store money or do I do what you all think is “right” and possibly eat $100/month x 20 patients/month.
My argument was that testing 5 times a day is an absolute waste if you can do absolutely nothing about it like most uncompliant type-2 diabetics. I know plenty of very compliant type-1 diabetics on insulin pumps or rock-solid awesome Lantus/Humalog setups and some very compliant type-2 diabetics who test once or twice a day and have A1c’s in the 5 range. I have patients who come to me (rather than their doctor) and say “Listen, I’ve been running in the 140’s every morning for the past week, nothing has change, can you talk with my Dr about increasing my medication?” As you all know, diabetes is one of those conditions that requires the patient to be an active part of their care and management, and I’d rather see the funds be used to paying for test strips for the complaint patients who actually /care/ about their sugar and test smartly than the non-compliant patient who throws tests away just so they wont get yelled at by the doctor during their next visit. Pissing away 5 tests a day does nothing unless you are doing something about it (and after 6 months when the insurance companies catch on, you should of done something about it).
Let me tell you a little secret. The reason why diabetes kills a ton of people is because the people who have it really don’t give a shit what happens to them and really want someone else to deal with their condition. Obviously there are people out there (ie: you) who *gasp* take an active part in their condition. If the insurance company audits me for test-strip usage and you get your meds filled every month as well as a blood sugar log printed out thats 20 pages I will gladly throw that back into the insurance companies face with a hard-on the size of the empire state building. However patients who actively manage their disease are few and far between. Most of my patients just take the pills, eat whatever the hell they want to eat, and just pretend that everything is okay no matter how many times I scream at them for having a 300 reading first thing in the morning. They dont feel pain, they dont really feel much of anything (other than peeing a lot) and life goes on. I can consult them until I am blue in the face, but until something BAD happens to them they will just pull the smile-and-nod game. Thats okay if they are paying for their stupidity, unfortunately they are on the system, so I tend to get a bit pissed since the taxpayers are footing the bill.
I know this sounds crass and crude, but I’m really surprised diabetes doesn’t kill more people than it does for the sheer lack of common sense and responsibility that I see on a daily basis, especially from “diabetics”.
Its sad really, but no matter how much you say they are going to die/go blind/renal failure/amputation most diabetics really dont give a rats ass about their condition.
Plus we need a token comment from someone who obviously arrived to the game LATE and with their shirt on inside-out:

You need to find a new occupation. This obviously is not your expertise or passion. While you are at it, go to school and learn how to use the English language to express yourself. If you can only use foul language, obviously you need some serious help in learning to express yourself intelligently.
oh….. have a nice day! 😛

Uh, what site is this again? I’m sorry, last I checked I was the ANGRY pharmacist. Obviously you need to go to school and learn to realize the obvious: that a site that has the word ANGRY in it is going to have some swearing and other ANGRY things in it.

14 and Pregnant – The Saga Continues

Amazing that I still get comments to my rant about the 14 year old pregnant girl. Before all of your pregnant teens jump down my throat screaming “RAPE” (since you all obviously think that EVERY pregnant 14 year olds was raped); Keep in mind that the original post did say that the father of said pregnant girl came into the store with her. I doubt if she was raped the father would be there.

this 14 yr. old WOMAN is not stupid or anything.

Uh, justify that please. How does having a kid when you are not even out of high school considering even remotely a smart idea? Unlike yourself, I would prefer to get an education and get a JOB so I can be financially stable enough to give that kid the best life I could. Somehow I don’t see this person accomplishing that.

14 yr old girls have desires and wants too.

Thats fine, I also have a desire and a want to not PAY for this child because the mother is an idiot. She should DESIRE to use a condom or some of the 100 billion forms of birth control. She should DESIRE to not cave into peer pressure and let some douchy fag tell her he’ll pull out in time. Plus you call her a WOMAN in your previous sentence, and a GIRL in this one. Stay consistent with your terminology please, you are just making yourself look like a bigger idiot than you already do. Choose one, GIRL or WOMAN. I am using GIRL because she is in fact that.

and her parents.. what are they supossed to do be
mad at her the rest of her god willing life??
huh? well if i had a daughter and she got pregnant at 14, i apsolutley know
i would be very upset and disapointed but i wouldn’t show it around other
people. and you would forgive ur daughter if that happened and you know it!

Being tolerant and forgiving is not expressing delight in front of other people. If I had a 14 year old daughter and she got knocked up, I would feel shame every time I went into public with her. Yeah, call me a hard ass but I would raise my child to be smarter than that. The chances of a 14 year old actually being successful in this day and age is close to nil. Not saying that it can’t be done, but most 14 year olds do not have the mental strength and determination to make it. Sorry if you don’t agree, but I’ll give you 100 examples of pregnant teens on the system for your 1 that actually makes it.

people make mistakes wheather they mean to or not they are just PEOPLE not
PROPERTY. and you have prob made a mistake too.

I dont make mistakes that last 18 years and become a financial burden. We aren’t talking about something that is unpreventable either. This is a completely preventable problem that takes a bit of common sense, 2 seconds of prep time, and a basic knowledge. Oh, and once you are on the state program I do consider you to be property. The state pays for you, the state owns you. If the state wants you to go pick up garbage and plant trees for 8 hours a day then you should have to. If you don’t like it, get off of welfare.

plus why is it any of ur
business if she wants to have sex and gets pregnant. its not ur life so why
don’t you just but the fuck out of her business and worry about yourself.
F.Y.I – when a girl first gets a period they turn into a woman. smarty.

Uh, I have to pay for said female and her crotchfruit now for the rest of their lives. All because the mother could not use preventable measures. So yeah, it does effect me, it effects all of us. Obviously from your horrible spelling you are either a teenager or someone who obviously did not finish school because you had a child at an early age. I wont hold this against you however, you just hammered my point home far greater than you could ever imagine.
Thank you for letting me know that when a girl gets a period she becomes a woman. I had no idea. All this time I thought that girls were in fact girls until they GREW UP enough to make smart decisions and support themselves. Getting knocked up at 14 not grown up, and not making a smart decision. This isn’t the 1920’s where you had children (and got married at 14) so you could have WORKERS for your farm. If you had two braincells in that empty noggin of yours you wouldn’t be defending this girl fully knowing that in this day an age an education is everything. If you want to throw your future away over an orgasm thats fine, just don’t do it on the dime of all of us who had a bit more common sense and foresight.

What? Medwatch? I’m confused

You state: Now I went to college for 7 years, got my PharmD, yadda yadda
yadda. I know about drugs. I am trained in drugs. Ask me about a drug
and I will tell you everything you need to know about it.
Okay–I’m asking about a drug: INSULIN. Tell me everything I need to know
about insulin . . . about older OTC natural animal insulins versus the rDNA
synthetic human insulin that is “just like the human body makes.”

What do you want to know about it? How its more consistent than animal derived Insulin? Less prone to allergic reactions? Longer shelf life (if kept in fridge)? Less shit from animal-rights groups (god save the pork?). Or should I go into the long tyrade about how EVERYONE can use this product without being forced not to get treatment due to religious beliefs of not using pork products? When I said “I will tell you everything you need to know about it” with Insulin its going to be how to store it, proper aseptic technique to inject it, when to notify your doctor, confusion about sliding scales, mixing, etc etc etc. Basic stuff they tell you in school. However you are a “50+-year insulin user” (See lilly rant) so I think you’re going to tell me that my 7 years of school + millions of bottles of insulin dispensed is completely wrong and I’m an idiot.

And while you are at it, I would like to know why pharmacists–whose years
of education supremely qualify them to serve as an intermediary between
patients and the FDA–have NOT stepped up to amerliorate the dysfunctional
adverse events reporting. It has been shown that patients talk to their
pharmacists 7 times more frequently than to their doctors. Ergo, you hear
more tales, more quickly, about adverse events; and yet you obviously have
opted to stay out of the mix, count your little pills, place them in
bottles, and ask patients, “Do you have any questions?” Your education and
position qualify you to do much more. Why don’t you?

If I reported every damn ‘side effect’ and ‘allergic reaction’ that I get on a daily basis, I would fill up medwatch’s books on “headache”, “upset stomach”, “dizziness”, “gives me gas”, etc etc etc. We filter out a /ton/ of bogus already-reported side effects from Medwatch. Now have I ever reported something to Medwatch? Yes. Woman had such a bad allergic reaction to the adhesive to Vivelle dots that it made a bleeding rash that spread. We arent “staying out the mix”, we are just nodding our heads and telling Mrs. Jones who calls you 100 times a day that YES, it is common to get lightheadedness when changing blood pressure medications, and if she wasn’t being such an uppity bitch about her copays she might of heard me warn her of that during the consultation. People hear what they want to hear, and the moment their copays change by anything more than $0.05 anything of value I tell them goes right out the window as they scream at me about their fucking copay.
I dont see where you are getting with this whole bitch to be honest. We ask the patient if they have any questions, yet don’t submit every side effect to Medwatch? Do you call the police about a missing person when your child cannot be found for 10 seconds because they are in the restroom? You’re probably one of those patients who has an “allergy” to codeine and tells us to record it as “upset stomach”, then argues with us when we say that its a common side effect.

In other words, what YOU perceive as your STELLAR qualifications could–and
perhaps will–be supplanted by a comprehensive PDR software program,
automatic pill-counter/dispenser, and voice-activated computer that can
spit out prescription inserts “on demand.”

Yeah, and who’s going to program said PDR software program that can turn medical speak into plain-person speak? How are you going to get around the Drug-Drug-Interactions/Dosing Mixups that aren’t picked up in the software but are picked up via experience (Morphine ER/IR mixups or a good starting dose for the elderly). We aren’t going to be replaced by machines because people like us, we talk to them.
Doctors have more of a chance of being replaced. They see patients for 10 seconds, take a quick look at them, and just leave giving them an Rx on the front counter. They could be replaced by an automated blood-pressure/DM/etc diagnostic machine, then patients can use a touch screen for their symptoms which spits out a diagnosis that then gets sent to the pharmacy where we pick out the proper drug and dose.

It sounds to me like you should be working at a mail-order pharmacy where
patient contact is minimum. That should take care of your ‘anger’ issues.
Then, of course, without those stupid, sick, suffering patients–and yes,
sometimes thoughtless or clueless patients–you wouldn’t have a job.

Do you realize that you are on the website “THE ANGRY PHARMACIST”? What part of “Angry” do you not understand? Have you ever read this site before? Do you realize that the whole reason /WHY/ I get angry is because I’m out there associating with everyone who walks into my store? This includes the village idiot, the whiny uppity rich bitch, and the 99.9% of the /normal/ people whom I don’t get angry with (hence not bitch about here). Did you read how I /hate/ mail-order pharmacies because they give substandard patient care and make /me/ do all of their shit work (when I dont get paid for it)?