Keep Yelling, That Will Make it Better!

Yesterday at work, 60% of the patients I dealt with within the 4 hours I was there, mentally beat me to a pulp. It was a horrible day in which I had to take a lot of abusive yelling and complaining and still keep on a smile. Experiences of why I do not want to become a retail pharmacists:

Women comes to counter to pick up her medication for a script that she dropped off earlier that day. We do not have the medication in stock so I tell her we have ordered it for tomorrow morning or I can call another store in the area and transfer the script. I immediately begin to get yelled at. The women was furious in front of her child, how could the store not have the medicine, why didn't we call to tell her, how could we be so disrespectful, why should she have to go to another store to pick it up, etc. I had to stand there and take it all and then apologize multiple times while trying to explain that we cannot possibly stock every medication and that I was willing to call another store and that I am sorry I was not there when she dropped off the script and that we have to run the claims through insurance before we even check the shelf for the med, etc. She calmed down but continued to complain about how inconsiderate of a person I am. Then a total 180 change when all of a sudden she needed my help finding a cold medication for her son, with "thank you darling".....Thank you, you know my what!

Another women drives up in the drive thru. She tells me her name and says she has a medication ready from last week. I tell her that we have nothing ready because we got her medication ready, it sat ready for over 7 days and then we put is back on the shelf. Legally we cannot keep ready prescriptions for more than 7 days. She begins to yell at me about how stupid of a rule that is and that she does not want to wait any longer. I ask her what medication she needed ready and then she yells at me some more because she does not want to say the medication name or what it is used for out loud. She yells at me that I am invading her privacy and providing poor service. I continue to get yelled at until I find one of the technicians who has seen this patient before and lets me know what the patient needs. We get the medication ready and get it to the patient. She drives off swearing and angry.

Plus about 5 more stories to match these two that came my way that day.

Come on people, have some patience, respect and humanity. I do not come to your place of work and just yell at you all day. I have learned how hard retail work really is due to the people you have to work with. Thank you to all the retail workers out there that don't get thanked enough!

Start the semester off on the wet foot!

When I got back to my apartment after being away for three weeks I was happy that the heat was working and that I was finally done with my five hour car ride. As I get into my bedroom to ambitiously unpack, I see some brown spots on my wall and ceiling. Yes, water spots. Then I look down at my bed and see that the top blanket has some dry water spots on it with some wetness in the middle. I hope that only the top blanket is wet. Of course as I peel back to the next blanket, it too is wet but even more so. Then I remove all the covers and see a nice puddle in the middle of my sheets soaked through to the mattress. What a lovely surprise for my welcome back to school gift!

The second day of classes was cancelled! Not because of a snow day, but because of an ICE day. The entire town from cars, to streets, to buildings were covered in a sheet of ice at least a quarter to one half inch thick. It took people a good half hour to chip away the ice off their cars and walking anywhere was a health hazard as slipping a sure thing. Too bad you I did not have a loosh to go sleeding on the ice!

Ever Seen an Open Heart?....I HAVE!

One of the most interesting experiences for me during my time at Rush-Copley Hospital in Aurora was the opportunity I got to watch an open heart surgery. The experience was tremendous because I do not think I will ever get the chance to observe a procedure like this again unless I go to medical school.

To be honest I was scared I would not be able to handle watching a surgical procedure because I am NOT a blood person (hence why I went into pharmacy and not med school). But I kept thinking about how the patient could not feel anything and that if I closed my eyes now I would never be able to observe this in my life again. I was able to stand directly at the head of the surgical table looking down at the whole procedure. If the patient's eyes were open and head not masked by towels, they would have been staring up at my chin which was about a 16 inches from their head.

I have a new found respect for surgeons, doctors and nurses as the procedure took 6 hours with no bathroom breaks, snack breaks or stretch your leg breaks. There were 2 surgeons, 2 doctors, 2 nurses, 1 anesthesiologists, 2 cardiac/respiratory machinists, and 1 pharmacy intern (ME) in the room along with the patient. The medical team stayed calm throughout the whole procedure with little that phased them. Each member knew exactly what to do, where to be and how to communicate effectively making the surgery room function like a well oiled machine with little room for error. Any abnormality was dealt with smoothly and concisely.

The room was more sterile than a bottle of bleach. Every instrument, counter top, machine, tube, etc. was sterilized and could not be touched by anyone but the surgeons who had on sterile gloves or breathed on by anyone as everyone had to have masks on as well as full scrub gear (caps, gowns, shoe coverings, etc). There was no way even a piece of dust could exist in the room.

I asked the surgeons how they stayed focused for 6 straight hours and they said that they live for these kinds of moments. They do the procedures the same way each time to ensure accuracy and precision. They portrayed a sense of calm while operating, even at the most critical moments as if they could not be shocked by a ghost passing through.

Every piece of equipment, every glove, every medication, every incision, every change in air pressure, etc was accounted for to ensure the patient's safety and well-being. Even when the patient's heart and lungs were no longer working for the body but a machine took over, the machine was monitored by two individuals every second as to match its function as closely as possible to the patient's physical function. The patient's lungs collapsed as the machine needed to oxygenate the blood since the heart collapsed as it needed to be drained in order to be worked on. The patient's body had to be cooled down in order to preserve cell function in every tissue and organ while the heart and lungs were "off". It is as if the surgeons must turn the body off for the procedure, do a full tune up and then bring the person back to life.

The surgeons had to cut open the heart to replace two heart valves, harvest some arteries from the patients leg and create a bypass for one of the arteries that supplied blood to the heart but was now blocked. Some actions seemed so crude, such as the cutting of the sternum bone and separation of the rib cage, yet most of the procedure was a scientific art , such as the sewing and placement of the valves so that they fit exactly with the rest of the heart muscle.

I used to think that surgeons were overpaid and over glorified for what they did but now I understand the time, money and care that goes into their work. They spent a great deal of effort making sure every precaution and extra step/effort to make sure the patient would not only have a fighting chance to live but would live as long as possible without complications. Watching the heart and lungs brought back to life and kick in again for the patient was beyond words.

The worst part for me was watching them sew up the skin because it reminded me too much of Silence of the Lambs movie but I got over it as I realized that this patient was going to survive thanks to everything that was done.

Hospital Experience...Not What I Was Expecting!

As I have probably mentioned before, in order to graduate and get licensed as a pharmacist, a pharmacy student must complete over 400 hours unpaid in a variety of pharmacy settings before the final year of rotations (in which over 1600 hours of unpaid work is completed).

I have been working on completing the initial 400 hours and am just about done. This past week I completed over 40 hours by working at a hospital in Aurora, Illinois, Rush-Copley Medical Center. Since this was only my second experience in a hospital, with my first experience being stuck in a hospital basement filling medication orders, my expectations were low and my anxiety high that I would not know enough.

Turns out, the experience was GREAT! I learned more about pharmacy, hospitals, professionalism, medication dosing, and myself then I ever thought I would. I now regret not putting down the hospital as one of my rotation preferences (which I turned in a month earlier). The hospital and all of its staff are very teaching oriented which made the experience worth every volunteer hour. My preceptor, Debbie, is a clinical pharmacist that has been helping pharmacy students for over 18 years and did not miss a beat when working with me. She is a phenomenal teacher, mentor and person. I was able to see and learn more in this week then many pharmacy and even med students see in one of their month long rotations.

Each morning I rounded with a team of practitioners including a pharmacists, a cardiologist, a medical resident, a respiratory therapist, a social worker, two nurses, and a nutritionist. We would visit and get a review of the progression of all of the patients in the Intensive Care Unit. This showed me how well a medical team can work together to get a holistic view of patients' health.

Each day I practiced monitoring and dosing for patients staying in the hospital on antibiotic IV medications or blood thinner medications. This showed me how important trust is between medical professionals as the doctors gave their full trust to the pharmacists to take care of the dosing of these medications for most of the patients in the hospital.

I was able to attend a meeting about infectious disease control within the hospital. Each area of the hospital has representatives present as well as an 'infectious disease control coordinator' (whose position I did not know existed). This taught me the importance of communication across specialties as well as the hospitals true goal of patient wellness.

I spent a few hours in the IV compounding hoods learning how different medications, nutritional feedings and chemotherapy agents are made. I was also able to practice my sterile techniques and compounding skills by making epidurals and compounded IV medications. I learned about the responsibilities of the technicians and pharmacists as well as the importance of precision and trust within the pharmacy department.

I was able to witness two "CODE BLUE" commands (one adult, one infant) which signify that the paramedics were rushing a patient with cardiac arrest into the ER. It was amazing how so many people could fit into one room and work together so well to try to save someone's life.

I was able to watch as a cardiologist placed a chest tube into a patient's lungs who was intubated but still having breathing problems. The doctor knew exactly where and how to place the tube between the man's ribs and into his lungs with little to no mess in about 20 minutes.

And the encore of the week, was that I was able to witness first hand an open heart surgery in which two heart valves were replaced and one coronary bypass was performed. This experience was definitely special as I do not think I will ever witness something like this again unless I were to go to medical school. The timing, precision, accuracy, knowledge, teamwork, and focus of all the professionals involved in the 6 hour long procedure is beyond outstanding.

To sum it up... This past week was AMAZING! My expectations were far exceeded with my knowledge from the experience more than I would have ever thought.

Comics Make Me Think

I LOVE to read the comics in the newspaper because they do a great job of making any life situation light hearted no matter how serious or daunting the situation originally was. Plus it is the only section of the newspaper that is not full of bad news such as deaths, killings, down falling economy, unemployment, etc. I was reading the comics (funnies as some newspapers call them) and one comic got me thinking. Most comics are not tremendously thought provoking but this one got me thinking about silly things:

Why do people call slacks a 'pair of pants'?

If it is because of the two legs, then why not call a shirt a 'pair of shirts' due to the two arms?

Why do we call lower undergarments a 'pair of underwear'?

Why not call upper undergarments a 'pair of bra'?

Why do people say 'act naturally'? (acting is not natural?)

What Did 2009 Teach You?

Here's a list of stuff we culled from 2009 that may have come as a surprise:

1. Domestic pigs can quickly learn how mirrors work and use them to find food.

2. Grumpy people think more clearly because negative moods trigger more attentive, careful thinking.

3. High cholesterol levels in midlife are associated with an increased risk of Alzheimer's disease and other forms of dementia later in life.

4. Analysis of Greenland ice samples shows Europe froze solid in less than 12 months 12,800 years ago, partly due to a slowdown of the Gulf Stream. Once triggered, the cold persisted for 1,300 years.

5. One mutated gene is the reason humans have language, and chimpanzees, our closest relative, do not.

6. Obesity in teenage girls may increase their risk of later developing multiple sclerosis.

7. A fossil skeleton of an Aardonyx celestae dinosaur discovered in South Africa appears to be the missing link between the earliest dinosaurs that walked on two legs and the large plant-eating sauropods that walked on all four.

8. Women who have undergone successful breast cancer treatment are more likely to experience a recurrence if they have dense breast tissue.

9. Babies pick up their parents' accents from the womb, and infants are born crying in their native dialect. Researchers found that French newborns cry in a rising French accent, and German babies cry with a characteristic falling inflection.

10. Surfing the Internet may help delay dementia because it creates stimulation that exercises portions of the brain.

11. The oldest known silken spider webs, dating back 140 million years, were discovered in Sussex, England, preserved in amber. The webs were spun by spiders closely related to modern-day orb-web garden spiders.

12. Scientists have discovered how to scan brain activity and convert what people are seeing or remembering into crude video images.

13. Pumpkin skin contains a substance that inhibits growth of microbes that cause yeast infections.

14. Hormones that signal whether whales are pregnant, lactating or in the mood to mate have been extracted from whales' lung mucus, captured by dangling nylon stockings from a pole over their blowholes as they surface to breathe. (This method could allow scientists to study whales without having to slaughter them.)

15. The higher a patient's body-mass index, the less respect he or she gets from doctors.

16. The blue morpho butterfly, which lives in Central and South America, has tiny ears on its wings and can distinguish between high- and low-pitch sounds. The butterfly may use its ears to listen for nearby predatory birds.

17. The ochre starfish or sea star pumps itself up with cold seawater to lower its body temperature when exposed to the sun at low tide. It is equivalent to a human drinking 1.8 gallons of water before heading into the midday sun, scientists say.

18. The eyes of the mantis shrimp possess a feature that could make DVDs and CDs perform better. By emulating this structure, which displays color wavelengths at all ranges, developers could create a new category of optical devices.

19. The calmest place on Earth is on top of an icy plateau in Antarctica known as Ridge A, several hundred miles from the South Pole. It is so still that stars do not twinkle in the sky because there is no turbulence in the atmosphere to distort the light.

20. The thrill of driving a sports car makes the body produce more testosterone. The findings suggest a biological explanation for why some men buy a sports car when struck by a "midlife crisis."

21. Remains discovered in China of a flying reptile named Darwinopterus could be a missing link between short-tailed pterodactyls and their huge, long-tailed descendants.

22. Bagheera kiplingi, a jumping arachnid from Central America, is the first known vegetarian spider. It eats nectar-filled leaf tips rather than other animals.

23. A massive, nearly invisible ring of ice and dust particles surrounds Saturn. The ring's entire volume can hold 1 billion Earths.

24. A new chemical compound that mimics the body's ability t o fight bacteria could be added to cleaning detergents to prevent bacterial infections in hospitals.

25. Seven new glow-in-the-dark mushroom species have been discovered, increasing the number of known luminescent fungi species from 64 to 71. The fungi, discovered in Belize, Brazil, Dominican Republic, Jamaica, Japan, Malaysia and Puerto Rico, glow constantly, emitting a bright, yellowish-green light.

26. Hormones in oral contraceptives might suppress a woman's interest in masculine men and make boyish males more attractive to her.

27. Women who revealed about 40 percent of their skin attracted twice as many men as those who covered up. Any more than 40 percent and the signal changes from allure to one indicating general availability and future infidelity.

28. Communities of 850 species of previously undiscovered insects, small crustaceans, spiders, worms and other creatures were found living in underground water, caves and micro-caverns across Australia.

29. The human body emits a glow that is 1,000 times less than what our eyes can detect.

30. If you're trying to attract a partner, an athletic body helps, but a good-looking face is more important.

31. Cockroaches hold their breath for five to seven minutes at a time through a respiratory system that delivers oxygen directly to cells from air-filled tubes. One reason they hold their breath may be to prevent their bodies from getting too much oxygen, which could be toxic to them.

32. Earth was bombarded in 2008 with high levels of solar energy at a time when the sun was in an unusually quiet phase and sunspots had virtually disappeared.

33. Scientists have discovered female eggs in the genitalia of a third of all American male smallmouth bass and a fifth of their largemouth cousins. Female bass occasionally show signs of male testes in their reproductive organs.

34. Nearly all animals emit the same stench when they die, and have done so for more than 400 million years.

35. Previously unknown molecules called hydroxyl radicals are produced by nature and are believed to act as cleaning agents that scrub away toxic air pollution in Earth's atmosphere.

36. A new species of giant rat was discovered in a remote rainforest in Papua New Guinea. At 32.2 inches from nose to tail and 3.3 pounds, it's thought to be one of the largest rats ever found.

37. Differences in body odors produced by people who are more prone to insect bites show they have lower levels of fruity-smelling compounds in their sweat than those who are resistant to mosquitoes.

38. A chemical component in broccoli can protect the lining of arteries from blockage that leads to angina, heart attack and stroke.

39. The length, curl and texture of a dog's fur are controlled by only three genes.

40. The speed of U.S Internet broadband lags far behind other industrial nations, including Japan, Finland, South Korea, France and Canada.

41. Polar bear skulls have shrunk 2 percent to 9 percent since the early 20th century. It's the result, scientists theorize, of stress from pollution and melting habitat.

42. A mysterious disease that killed off more than a third of American honeybees in 2007-08 may have been caused in part by a virus.

43. A group of deep sea worms dubbed "green bombers" are capable of casting off appendages that glow a brilliant green once detached from their bodies. The tactic is believed to be used by the worms to confuse attackers.

44. A flesh-eating pitcher plant that grows more than 4 feet long can swallow and devour rats that are lured into its slipperlike mouth to drown or die of exhaustion before being slowly dissolved by digestive enzymes.

45. An orchid on the Chinese island of Hainan gets hornets to spread its pollen by producing an aroma identical to that made by bees under attack. The hornets feed on bee larvae, so when they get a whiff of the alarm pheromone, they head to the orchids figuring bees are inside.

46. More than 350 new animal species were discovered in the eastern Himalayas, including the world's smallest deer and a flying frog.

47. The spleen is a reservoir for huge numbers of immune cells called monocyte. In the event of a serious health crisis, such as a heart attack, wound or infection, the spleen will disgorge them bloodstream to help defend the body.

48. The Amazon River is about 11 million years old and took its present shape about 2.4 million years ago.

49. A close relationship with a caregiver can give Alzheimer's patients an edge in retaining brain function over time.

50. Watermelon is more efficient at rehydrating our bodies than drinking water. It contains 92 percent water and essential rehydration salts.