Monday, April 30, 2012

I am back...Why?

I am shocked!! I just noticed the date of my last blog posting. It is clearly evident that it has been so long since I vented, that I have lost the last two people in the world that were even remotely interested in my health care insights. And...quite frankly, I think they were close family members, just peeking in once in a while to see if my rants were turned down to a rolling boil. Hey, I am not angry a druggist, I'm just at an age where I don't suffer fools lightly and I might be a tad grumpy about the state of affairs behind the pharmacy counter, but at the end of the day, I would very much like to see a smarter pharmacy patient. All parties would benefit and I am betting my next paycheck, it would lead to big savings on the health care dollar. With frustration running high of late, today's writing is personally therapeutic and I suppose a little self-serving Hey...I can live with that! Maybe, I can slowly woo those few readers back with a few tips. I have seen the quality of writing from outspoken pharmacists on tons of topics; some whimsical, some tragic, and some very thought provoking. Given the right chance, I just might be able to find my little niche in the world of pharmacists that can both count to thirty and also comment on the issue at hand withouht leaving a dangling participle. There is nothing wrong in wrappping up a "pet-peeve" in a small box of "edginess", is there? I want to get the readers attention, but I don't desire to be obnoxious about the whole affair. So.... True to my mantra of the 3 "Bs," I shall Be Brief, Be Brilliant, and Be Gone. I ask a simple question to all of us pharmacy partons who just might have been guilty of the following breaches of etiquette. I want to simply ask..."Why?" -Why do we wait until Friday evening to request a prescription refill with NO refills, knowing full well we are "leaving town for the weekend?" or better still, "in a couple of hours?" -Why do we think the pharmacy dictates the price our insurance company is charging us for our prescriptions? -Why do we think that a pharmacist will fill our prescription faster if we stand at the pick-up window, pounding out Morse Code with our debit card? -Why do we and the pharmacist count 30 days differently when it comes to Hydrocodone/APAP prescriptions that must last 1 month between refills? -Why do we think that our physician requires an insurance card at time of service, but is unnecessary at our local drug store? -Why do we think that pharmacists learned an extra skill set in pharmacy school as a grocery checker? -Why is that we feel okay about calling our pharmacist and requesting to refill "all the usual prescriptions I usually get every month?" -Why do we think that in the pharmacy, 20 minutes actually means 5 minutes in prescription processing time? -Why do we think that a pharmacist can easily fill our prescription 5 minutes before the closing hour, because we are sure he doesn't want to get home after spending 10 straight hours on his feet? -Why do we feel the necessity on arriving at the prescription drop-off window to immediately stick our head inwards and yell at the top of our voice, "Yoo-Who!" as if those 2 seconds of wait time on our part was extremely unreasonable? -Why do we think our local pharmacist is obligated to solve our mail-order pharmacy problems and many others that he or she might not be qualified to do so? (I do believe that is a dangling partiple situation!) Okay...I think I have made myself clear and not too insulting. Next time you fill that prescription, feel a little for that overworked guy in the white labcoat...and remember, Take as Directed! blake

Tuesday, November 1, 2011

How does the horror flick end?

Yesterday, was Halloween, and as I get older, I like the marking of All Hallows Eve less and less. In fact, 3 years ago I was given the scare of my life...literally.

If you are the 1 or 2 people following my "journey o' blog", you will remember that on 10/31/2008 our family was hit with our own personal tsunami(2008 wasn't the best year for a lot of us, you must agree). My youngest daughter was in the OR for a critical leg surgery. We were impatiently waiting outside for the results. Bone cancer was a possible outcome. Bone infection was the other option. As you would guess, neither was a trick nor a treat at the time!

We marked the occasion last night over pizza and soda and all things considered, we are all healing physically and emotionally. It will take some of us longer to get closure. However, one could make the case of not completely shutting that door, lest we forget the experience and lessons learned. Obviously, there was some second guessing on my part regarding all of those past healthcare decisions impacting my family. I suppose that was to be expected. All of the "woulda,shoulda,couldas" came gushing out.

But here is the thing. Here, indeed, is your prescription that hopefully keeps you from being too worried or whining too much or second guessing yourself, or thinking "I am just too exhausted to continue!" amidst my personal health care crisis. And by the way, I have been a active participant in all of the previously mentioned counter-productive behaviors.

This life saving "medicine" is the assurance that you will get through the crisis (despite screwing things up more times than you can count). Without any additional pharamaceutical help, your present situation will be soon a past situation. Embrace the change. Think of it as being trapped into watching a bad horror flick (painful as it is). You desperately want to see how this ghoulish story ends. However, as luck would have it, the DVD goes belly up, dashing any chances to catch the story's conclusion. It may be a while before you are able to purchase a new, fancy BlueRay/DVD player and re-rent the movie. The waiting game is on.

Like this goofy analogy, we have little control over outcomes, especially when we desire them the most. However, rest assured, they will find us, regardless of its nature. And that is a good thing, in its own twisted way. We now know! I dare say, life would be both monotonous and unfilling if things were any different. There is great value in historical perspective in this portion of life's journey. We get to make the judgement call on whether the tincture of time is powerful medicine for healing of our souls. And please remember...Take as directed
blake

Wednesday, October 19, 2011

Two ears, one mouth!

The "Talkover"...I hate it. It pushes my buttons in the worst possible way and creates a huge mass of human rage, from a fairly easy going, friendly pharmacist...occasionally like me!

So, what am I talking about? Remember? All of us have been victims. It is the person that thoughtlessly ambushes you half way in to a conversation where a cogent thought might be useful...say, counseling a patient on a new medicine. They talk "over" you with a question or a lecture or a whine or a complaint, or a whatever... before the first syllable is out of your mouth. It is like a listening disease! Its symptoms are closed ears and open mouth and usually with a foot in that same mouth, following close behind. Hello...two ears one mouth, ya'll!

Take today. If this patient at the pharmacy counter would have let me finish my thought (and I was fairly confident that I knew what I was talking about) before he popped off as if I was the stupidest guy in a white lab jacket, our verbal exchange wouldn't have escalated to ,"I don't like you Mr. Pharmacist!" and in response, "Quite frankly, Mr. Patient, I am not real fond of your present attitude either!" It didn't end well, but I deftly defused the situation... by what else? I walked away. Oh...that was mature!

So what does this have to do with being a better health care receiver and advocate? Isn't it obvious and yet almost impossible to accomplish? Improve those listening skills, rookie! Get in the game!

Oh, by the way, physicians are not immune to the "Talkover." Neither are pharmacists. In fact, in many ways we can become experts. This is not good. Just for giggles, be your own referee. On your next doctor's visit pay close attention to his or her "doctoring" listening skills. You make the call on the "Talkover" infraction. If you have to, throw the penaly flag! They should be trained listeners, although I have seen some disturbing exceptions on the health care field. Nevertheless, they are trying to dial in to what you are saying with both the verbal and non-verbal signals. Hold them to that standard. Many are very good!

And just for good measure, how about turning the tables on the well educated, highly trained doctors? First, don't do the "Talkover!" Stake your health claim quickly and sit back and listen to the MD's response. Stay on point and you will be enlightened. You will know your provider's level of investment, interest, expertise, etc. My daughter saw nearly 34 physicians before a trip to the Mayo Clinic nailed the diagnosis. THIRTY FOUR! She can immediately tell, within seconds into an appointment whether a doctor is genuinely engaged with her medical care or politely (or sometimes not so politely) dismiss her.

Remember, you are ultimately responsible for your health care and active listening is one of the first steps. It starts with your own body and mind. Trust yourself and act...move and listen...and then act again. Incidentally, follow up questions during these brief but critical moments with your doctor is not and I repeat not the "Talkover!" Just be wise with your timing.

Okay...I'm done, lest you criticize me for the "Talkover" and after today, I just might be very close. Beware of creepy Halloween pranks and of course... the "Talkover." Remember....Take, as directed!
blake

Monday, October 17, 2011

Option is not a Failure!

It will happen, especially if a serious or indeed life threatening illness plays a family member like Whack-A-Mole; with the MD holding the Whack! I know what I am talking about, because I saw it first hand on the face of an ER physcian who thought he was option-less in helping my daughter. They won't let us admit her," said he. "What do you mean we are out of options?" I asked, panic stricken.

As you would guess, it is a hopeless feeling, but maybe more disturbing is the newness of that emotion for families experiencing their initial big health care crisis. I was stunned at the response. I had never heard such a thing and certainly this couldn't be happening in the 21st century. Are you telling me that the on-call orthopedic surgeon at the local hospital was not going to admit my daughter because of his hubris, ingorance, a poor judgement? If your remember, the reason was that his colleague instructed him not to do it because he thought my daughter was a drug seeker! Well, on hindsight, he was precise but misguided in his clinical assessment. After all, her femur shattered because of mis-diagnosed bone infection,so I'm guessin' she was looking for some pain relief in a round about way. Sorry, I flew off on an emotional tangent there for a sec...oophs!

So what is my point? As an educated health care recipient (and I mean get educated! Don't be coming in to my pharmacy not knowing what your doctor was supposed to be calling in for that nasty sinus infection!) and a advocate for that sick loved one, NEVER and I mean NEVER believe that you are out of options to get the needed treatment. You think that any doctor would accept that kind of "Sorry, there is nothing I can do?" response from one of his own. Believe me...he would fire the doctor and find a new one. I have done it and it was nothing personal. It was a matter of reminding that health care provider that I pay the bills, or more correctly speaking, my insurance company ponies up and then I disagree on the treatment approach.

And, guess what? You will find plenty of doctors out there that share your sentiments. A fiesty former Army Doc, also on duty that night, gladly shattered protocol, called and end run, and in less than an hour, my daughter was in a hospital bed, Morphine on board, and all vitals good. She was brilliant enough to not accept that woefully outdated argument of "Well, that is the way we have always done it around here!"

It will be a challenge to literally think out of the box and encourage that health care team that surrounds you to do the same. You are in crisis mode, so emotions are high and logic is suffering, Fear not, because those health care providers, like you, are are product of life's experience full of great and not so great ideas. Push 'em a little and ask what they would do if this were their child or mother or wife? If necessary take them to the brink of surrender. It won't be hard, most of them are overworked, sleep deprived, and often pick their battles wisely. I think that the pharmacist and doctors got so weary of me popping off as a pharmacist, they started asking me my insights about pain management to help my daughter and ultimately themselves (figuratively speaking).

Today, after three years. my daughter is thriving under the care of a skilled accupuncturist. And....this conservative, western medicine, trained pharmacist (aka,me) could not be happier. You listen to your intution. It is sometimes as valuable as that skilled surgeon or that new chemotherapy medicine. Even in the most sobering situation where thoughts and actions are so intense, almost surreal, you still have the option of doing NOTHING and leaving the outome to a force much greater that yours and mine. It can be liberating to be in that much control

So remember, if you think your out of options, maybe failure is the one! Just think about it... and of course remember...Take as directed.
blake

Saturday, October 15, 2011

Is the network picking us up for another season?

Darkness starts its rounds a little earlier each autumn day in the Northwest. It has been over a year since I have found the energy to write and 3 years ago when our family got schooled in the realities of healthcare as we presently know it. As you remember, two of our three children were prized pupils.

The twisted melancholy of the cooler season has drawn me back to pen some thoughts. Tis no big secret blogs evolve, mostly for the writer, since in my case there are few followers, but they are most loyal. I like loyalty. I applaud loyalty!

Moving forward...I think I will continue my/our/your story. Call it an occasional medical theme of sorts, if you like, or think of it as the network gave the go ahead for a few more episodes of "U.S. Healthcare"...without the ratings to justify the quality. It is my little way of sticking it to FACEBOOK social networking crowd, since I don't do facebook. (I do have my reasons and they are obnoxiously dogmatic! A topic for later rants).

I like the idea of helping those individuals facing crisis with medical care. On the self serving front, it will ultimately be cathartic for me. I do get a little PTSD when I visit a hospital at this time of year. Any therapy is good therapy, the way I see it. That is my way of saying that I empathize with the struggles of those care-givers trying to take care of loved ones when they are seriously ill. Wanna here some irony. My daughter Michelle is always telling me, "Dad...get over it!" And I wasn't even the one with ICU time and a couple of surgeries under my belt

So, in the spirit of non linear thought, I shall write of random events surrounding our health education here at the Nelson's. I think you will agree that I have had some time to digest a couple of years of memories. By the way, if your curious regarding the state of health of my "N of 2" (that's statistic talk for my 2 children)they are getting on rather nicely. Let say their progress is directionally correct, but as of yet, not made whole.

I have learned much and committ to staying away from the weary, whining, worried camp with my posts. I will just share a simple narrative of hope and hope people get it. Please remember, I intend to offend nobody and I am not that angry. My perspective still comes from a pharmacist, former big pharma lackey (sic), and a father that watched his kids get sucked into healthcare...for better or worse. In fact, it might be a good idea for you to do a quick review of my older posts, so that when my season opener comes around, you will have a nice little medical history in that fancy "chart" of yours.

If my efforts or hobby or "whatever you would like to call it" is occasionally thought provoking...cool! So, to all my friends, enemies, and frienemies, knock yourself out. Humor me every once in a while and drop in. Remember, "Take...as directed!"

Wednesday, August 11, 2010

Humor Me after I pay the bill!

My youngest daughter just completed her latest surgery; a mere tune-up of sorts compared to her past dramatic health history. However, this rant has nothing to do with her oral surgery... rather it is all about another form of inflicted pain: Payment of Services Rendered.

Of nothing else, my experience has taught me the value of due diligence when it comes to insurance coverage. It is an extremely arcane world, understood only by its sordid designers. They talk of "EOBs,In Network versus Out of Network, co-insurance,co-payments, and maximum out of pocket costs." And...those are the things that I understand! I was confident in my prepratory efforts and expected all players in this health care game to claim victory. Fat Chance!

Regretfully, the pain I referenced earlier came from a most unexpected site. The female keepers of the finances! Oh sure, it is all fun and games at the front office and in the back exam room. In fact, one couldn't help thinking that the oral surgeon might be akin to Captain America. The supporting cast was also accomodating, professional, and slapped on their best patient advocacy faces,(which included dazzling-white bleached teeth). And why? Simple...the money for service deal hadn't gone down yet. Make no mistake, they WERE helpful in the "I will show you HOW to get the money so I can quickly take if from YOU and then get GRUMPY" category. Well...maybe grumpy is a tad severe. How about: deliberate indifference! That ticket is even worse...at least, grumpiness takes a little forethought! You see, my daughter had a little post-op complication requiring attention. Their response, "I am sorry, what did you say her name was again?" Seriously...

So next time your scheduled for a some time "under the knife", enjoy the joyous preliminaries, because after your cash will soon be parted, you will continue be sliced up! Tragically...typical!

Remember...take as directed

blake

Friday, July 23, 2010

Tell me where it really hurts?

I can no longer bear listening to Jesse Jackson, President Obama, or the occasional NPR pundit. It is just too painful! Why, you may ask? The reason, the discussion thread is all scripted. Where is the emotion, the spontaniety, and cutting to the chase? Give me some Hydrocodone and fast! Oh wait, that might prove to be too difficult!

To that end, I am throwing away my well thought out communicative approach and write from my cold, calculating heart about this subject. You see... me, a Dad, a pharmacist, can't get a prescription to ease my pain to save my life or better still, my daughter's life!!! Check out previous blogs and you will see, pain management is a big deal with her. And yet, last week after her 5th surgery in the past 24 months, she is still dismissed as a Hyrdocodone seeker and worst, her concerned mother, treated as white trash on the score. Seriously, Haven't we seen this movie before?

So...here is my solution. I have discovered after standing behind the pharmacy counter for years, our family is going to fulfill the expectations of those indifferent surgeons (who by the way, have rarely had surgery and thus, poor pain advocates). I am quitting my job, applying for state assistance, move into a "van down by the river." That will give me plenty of time to focus on clever reasons on why I should get my Hydrocodone for that pesky "skin condition." Those are the people that seem to get the prescription without a hiccup.

In short...I know pain managment is going to be looking good around the old homestead. I now know where it really hurts!

And remember...take as directed

Blake...your future un-employed pharmacist