Yearly Archives: 2016


Throwback: A Strange Hour of a Sunday Shift

This is a post I wrote a LOOOONG time ago, on my first blog.  Even though my industry and schedule has changed, what people want from me has not.

Originally posted October 3, 2011
I don’t work many Sundays, but this past Sunday I did so a co-worker could have the weekend with her family to celebrate her birthday.
And on the Sundays I do work, strange things seem to happen.  Not sure exactly why, though I do have my guesses:
  1. The hangover is gone.
  2. People go to church, get convicted of the weekend’s activities, repent, then come looking for solutions to the consequences realized.
  3. They think everyone else is at church so business will be slow, or they’ll avoid the judgmental eyes of the church-goers.
So, I had a very strange hour this past Sunday at work.

Customer #1

A man and his son.  Dad had skunk-streaked hair (as in dark on the outsides, white/gray down the middle), and the 15-year-old son was linebacker sized. The kid had a sinus infection and needed an antibiotic.

Customer #2:

An Ex-Marine who ran the 6-mile Currahee Challenge.  (If you’ve ever seen the series Band of Brothers, they were guys who trained at Camp Toccoa during WWII and running Currahee Mountain was all in a day’s work.)  This guy came hobbling to the counter.  He informed me that he had been out of the Marines for only a month and that running 6 miles should’ve been easy.  He described his pain and told me that “Icy Hot from hips to toes on both legs wasn’t working.”  Ibuprofen and real ice was a better option (and less smelly).Customer #3:  Nervous guy – he asked about purchasing Plan B.  I have

Customer #3

A nervous guy came up and asked about purchasing Plan B.  I gave him the 3rd degree: Who’s it for? How old are you? What about her? How long has it been? It’s funny cuz the guy’s squirming.  I sold him a pack: $53.  He calls a few minutes later and says “this box says for 17 and younger.  She’s not 17!”  I informed him that the label should say ‘Rx only for 17 and younger”, meaning if someone younger than 17 is going to use it, it requires a prescription from a doctor.  He was highly relieved (obviously if he had gotten the wrong thing, “the lady” was going to be angry!)
*Currently, Plan B contraception is fully OTC, the Rx requirement has been removed thanks to legislation from President Obama.*

Customer #4

The girl from the Chinese Buffet came in.  She is really sweet and I like helping her, but communication is a challenge. You’ve got to be able to laugh at some of the mistakes we make.  Today, she came in asking for advice on “cold medicine for a duck.” A duck?  Really?  I asked about symptoms, she said: “his nose is noisy”.  I head for the children’s medicine thinking “we can dose a duck by weight”, so I ask how much he weighed.  She said 140 pounds.  A duck?  Oooooh, adult!  She never knew I thought duck as in “quack quack” duck.  We got her dad some cold medicine and she was happily on her way.
Just another random Sunday at the pharmacy!

I Think You’re Smart [Show Notes]

I think you’re smart

You’re smart, I know you are!  I want you to apply those smarts and help me out a bit.

Piles of information thrown at us about our health, some new treatment or medicine, or some new aspect of a disease.  The media is flat out MEAN about how and when it presents this information.  Usually, it’s incomplete, biased, and twisted into a scare tactic.

Anyone with a brain will know that anything in excess can be bad.

Some tips on judging the source of information

  • Are they trustworthy?  Have you even heard of them or their site?
  • What is their reputation of presenting “shock and awe” headlines just to get views, clicks, or attention?
  • Is it a celebrity or politician who wants some screen time and just wants to be the loudest voice in the room?

Critical thinking is a dying skill, please don’t let it go extinct.

Consider the Source

Science and medical information is classified based on how close to the “horse’s mouth” it is.  Scientists who do the study, write the reports and articles, and publish it in journals themselves – those are called primary sources.  To be trustworthy, they have to state any limitations their study had, confounding factors, and any biases (aka money paid by someone who cares, like drug companies or lobbying groups).  Then there may be a group of scientists or statisticians that take several primary resources that studied the same thing and compare all their outcomes and come up with an overarching conclusion – those are called secondary sources.  Articles that reach the public and may have citations of using primary or secondary sources for some of the information presented are called tertiary sources.  They are so far removed from the primary source that they CANNOT be used for academic research!

Again, critical thinking skills are vital for our success in society.  Don’t follow the fads!  Don’t allow yourself to be duped by people who line their pockets with money from people who are ignorant about the subject they’re screaming.

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5 Things Your Pharmacist Is Not [Show Notes]


5 Things Your Pharmacist is Not

  1. A mind-reader (neither is anyone else)
  2. A robot (as is anyone else who serves you)
  3. A prescriber or diagnoser
  4. “Besties” with all the doctors in town
  5. Your personal assistant or secretary

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DIY Diaper Cream [Show Notes]

Diarrhea is not fun, diarrhea in kids is not fun, diarrhea in kids in diapers is certainly not fun.  Diaper rash can flair in just one or two diaper changes.

Diaper rash products

  1. Protectant ointments: like vaseline, kind of greasy but provide a moisture barrier to keep the skin’s moisture levels from getting out of balance.
  2. Zinc Oxide: like Desitin, white or opaque and thick, keeps the moisture in the skin in, and the moisture outside the skin out.  More completely covers diaper rash so really sore spots can heal faster.

Diaper Rash

Some diaper rashes are caused by a yeast imbalance, so doctors may recommend an OTC or prescription yeast cream.

Sometimes diaper rashes can be really itchy (even though little babies can’t tell you they itch, so all they do is cry), so OTC or prescription steroid creams can be used.

Diaper rash from diarrhea is usually caused by acid that is released in the liquid stool.  For babies in diapers, when acidic diarrhea exits the body, it hurts; but then it sits in the diaper and continues to hurt and irritate the skin.  Not to mention the irritation that may have already occurred due to frequent diaper changes.

A frequently recommended fix for diaper rash is air.  Letting the rash air dry and not be closed up in a diaper can work a lot of times.  That doesn’t sound like a great solution if baby has diarrhea.

There’s a butt paste that pharmacies can compound with a doctor’s prescription.

Recipe

  1. Aquaphor ointment (OTC) – kind protectant
  2. Mylanta (OTC) – antacid to neutralize acid
  3. Cholestyramine powder (Rx) – medication that treats cholesterol by trapping up lipids in the intestines so the body doesn’t absorb it – it can trap up bile that comes out in the stool

You can use 2 out of the 3 ingredients and do this yourself with a couple tools in your kitchen!

  • Heat the tub of aquaphor on a hot plate, or warm it in a double boiler, until melted.  (You don’t want to have to remove all the ointment from the tub to melt b/c you’ll waste some and it’ll be really gooey).
  • Add 2 Tbsp (30 ml, 1 fl. oz) of Mylanta to liquid Aquaphor and stir well.
  • Let it cool!  Do not put warm ointment on your baby!
  • Apply to baby bum as needed for diaper rash.

Doesn’t have to be just for babies….

Anyone who has had diarrhea and experienced the burn from the acid and irritation from frequent stools can benefit from this product.

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2 Ways to Help Your Pharmacist [Show Notes]

2 things you can do to help your pharmacist help you better

  1. Have patience.  The pharmacist is one person, and they have one mouth and one set of ears, and can only listen and talk to one person at a time.  You want undivided attention, and we want to give you undivided attention, and to get that, there may be a short wait.
  2. Be honest.  Full disclosure is important when it comes to your health conditions, allergies or intolerances, and questions or concerns about anything related to your health.  Pharmacists in most states have a legal responsibility to counsel or offer counseling to patients in certain situations, but they can’t read your mind.

Sorry for the soapbox! (Well, maybe I’m not!)

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3 Ways People Get it [Show Notes]

Three characteristics of people who take charge of their health

  1.  Stop placing blame.  It’s not my fault electronics malfunction, and it’s not my fault the nurse hasn’t returned a phone call.
  2. Get the whole story.  They find out what I’ve done, they find out what the doctor’s office staff has done, they find out what their insurance has done… because there’s more than 2 sides to a story.
  3. Take decisive action.  If they learn something new about their situation based on the 2 things above, they take action to make progress towards getting problems solved.

The big picture

They take responsibility for their own health.  If there are steps you can take on your own to get the outcome you desire, take them.  If someone on your team isn’t meeting expectations or doing their part on your team, you get to choose: do you talk to them and get on the same page, or do you choose someone else to be on your team.

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Reflux vs Ulcer [Show Notes]

Gastro-Esophageal Reflux Disorder

GERD, or just Reflux.

Reflux is a word that is used to describe something in your body that flows backwards.  The fluids in your body have a certain direction they naturally flow for your body to work properly.  If they start flowing backwards, it’s called reflux, and can lead to problems.

Is that like heartburn?

Yes, heartburn is a type of mild reflux.  Something (like a certain type of food or overeating) causes the stomach acid to bubble back up into the esophagus.

Overeating or other physiological disorder can cause the lower sphincter to not close tightly or completely.

Ulcer

They lining of your stomach produces the acid, thus it’s intended to be resistant against the acid.  The lining of the esophagus is not intended to handle that acid.  And stomach acid is way more acidic that our saliva or acidic foods that we may eat.

Now, if the acid-producing (and acid-resistant) lining of the stomach wall gets injured, and the layers underneath come in contact with the acid, it causes pain.

Would that cause someone to throw up blood?

Yes, it possibly would.  Any tissue that is living and working in your body, requires a blood supply to bring in nutrients and carry out waste.  So, the walls of your stomach is full of blood vessels.  If the acid, eats through the layers and gets to the blood vessels, that blood will spill into the stomach.  Unfortunately, your digestive system isn’t intended to digest large amounts of blood.  The pain from the acid plus the large amounts of blood can lead to nausea and vomiting.

How I assess ulcer or reflux

Where does it hurt?
– Reflux: in the esophagus or throat (even to the point of hoarseness)
– Ulcer: Stomach

Does it hurt worse when you’re hungry or after you eat?
– Reflux: hurts after food has gone into stomach or you lay down at night because you don’t have gravity holding the acid down into the stomach.
– Ulcer: hurts when the stomach is empty because the acid only comes in contact with the stomach lining, rather than having food to work on.

Treatment

The treatment for both is the same.  The goal for both is to reduce the acid production.  People will try to self-treat by taking tons and tons of OTC antacids (liquid or tablets).  Antacids are bases, so they goal is to neutralize the acids, but once that amount has moved into the intestines, the base is gone and the acid is till there.  Other acid reduces are OTC as well.  Histamine 2 Receptor Blockers (Pepcid, Zantac) can start to work within 30 minutes.  Proton Pump Inhibitors (Prilosec, Prevacid, Nexium) can take up to 2 weeks to reduce the acid, so not intended for instant treatment.

Bottom Line

Whether it’s ulcers or reflux, your doctor needs to know what’s going on so they can monitor your progress.  Anything that manipulates cells in your body (whether stomach cells damaged in an ulcer or esophageal cells being corroded by acid) can cause cellular changes that may become cancer.

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Lice [Show Notes]

Myth #1: Having lice means that you’re dirty

Truth: Lice like clean hair.  When you shampoo, the soap strips your hair of its natural oil.  So while you think your hair is clean, it is also very grippy.  Thus, lice can hang on better to move around.
Solution: Don’t wash your hair – ha!  At least allow your natural oils to stay in your hair, or use a leave in conditioner or other product that makes the hair “slippery”.

Will dry shampoo attract lice if you’re not washing your hair?
Dry shampoo works like baby powder – it absorbs the excess oil and moisture, but doesn’t dry out the roots of your hair as soapy, foamy shampoos.

Jump on the no ‘poo bandwagon!

Myth #2: Live for a long time off your hair

Truth: Lice require a warm place and a blood supply for survival.  They like to hang out at the base of the head and neck and around your ears.  They may fall off on couches backpacks, and car seats, but they rarely survive there long enough to transfer to someone else.  It is mostly spread by head to head contact (sharing a bed, sharing a hairbrush).

Myth #3: Pets can carry lice

Truth: They are only spread human to human.  Other parasites that like humans (i.e. mosquitos, fleas, ticks) can be spread by pets, but lice cannot.

What to do?

The overuse of over the counter pesticide products that kill lice is encouraging them to build up resistance.  Critters, large and small, will change and mutate to ensure their survival.  This is why the news talked about them as “super lice”.

Good news:  They’re not resistant to vinegar.  Diluted vinegar is not harsh on your hair and doesn’t strip oils, but it can dissolve the glue that hold the eggs, or nits, onto the hair shaft.  This will allow the eggs to wash out or be combed out easily.

Tea tree oil is intended to suffocate them or repel them completely.  No proof that it’s really effective, but it can be mixed with the vinegar to help your hair smell better.

Some of the standard chemical products can be very strong and not intended to be used on children under a certain age.  Some of the chemicals work by disrupting the parasite’s DNA and neural system, humans are just way bigger than lice so it would take way more to hurt humans, but the risk is there.

Lice furniture spray – intended to be used on furniture that has long exposure (4+ hours) with the infected person.

If there are positive signs of lice, it may take more than one round of treatment and combing to get any new ones that hatch.

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Don’t Share Your Cold [Show Notes]

Cold Virus

Rhinovirus.  Rhino = nose.  The cold virus accesses the body through the nose and mouth, and it uses the cells in the sinuses and throat to replicate.

Viruses require a host cell to replicate, therefore they don’t live very long outside of a host.  The cold virus can live on a surface for about 3 hours.

During the initial infection and multiplication stages (first 3 days), you are the most contagious even though you have no symptoms of being sick.

Cold symptoms

  • Runny Nose
  • Scratchy throat
  • Cough
  • Sinus congestion
  • Tiredness
  • Mild fever
  • Possible body aches

“Morning sniffles” not a cold.

Your tonsils are a major hub of your immune system. So, when your body recognizes that it’s been infected by a virus, the immune system is activated.  Sometimes, the first symptom people experience with a cold is a sore throat because the tonsils go into overdrive when the immune system is activated.

Prevent a Cold

Always wash your hands (in soap and water or hand sanitizer).  Touching your face can allow germs to enter your body but can spread your germs to other surfaces or people.

Learn to sneeze or cough into your elbows.  It keeps the spray from getting on your hands or surfaces and items around you.

Use sanitizing wipes to clean surfaces you may touch regularly or that you know someone sick has touched.

Why don’t we vaccinate for the cold?

Vaccines are prioritized a few ways.  We want to vaccinate against things that:

  • kill people.
    Colds don’t kill a lot people, they just make us miserable and miss work.
  • spread really fast.
    Flu, measles, chicken pox all spread rapidly through the population due to droplet exposure.
  • have slow-changing characteristics.
    There are 99 different version of the “cold” virus, but each one is fundamentally different.  So you would have to get 99 vaccines!

 

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The Flu or an Imposter? [Show Notes]

5 other viruses that cause “flu” symptoms

  1. Rhinovirus (cold) – most colds don’t come with a high fever, but the other symptoms are present.
  2. Coronavirus (SARS) – includes gastritis, nausea, and vomiting on top of the other symptoms
  3. RSV – usually prominent in kids and leads to hospitalization due to the respiratory inflammation that can lead to an emergency
  4. Adenovirus – first isolated in the adenoids; responsible for viral tonsillitis
  5. Parainfluenza virus – in the 50’s, they would swab the mouth or throat to determine what was making a person sick.  There was a group of kids sick with the “flu” symptoms.  The doctors swabbed all these kids and noticed that some showed a virus that wasn’t the influenza virus they were used to seeing, so it’s name essentially means “around influenza”.

These viruses have nothing in their makeup similar to influenza, therefore, the flu shot will not protect you against these.

Are flu shots really worthwhile?

The short answer, yes.  It not only keeps the shot-getter protected (and even a little protection is better than none at all), it keeps healthy people from being carriers of the virus from spreading it to weaker members of the population (little kids, elderly, immunocompromised).  And while the flu isn’t the primary reason people end up hospitalized or dying, the secondary complications (i.e. pneumonia) are what can kill people.  Getting the flu shot is a simple and quick process, and is also relatively painless.

And there is absolutely NOTHING in the flu shot that can give you the flu.  Your body can have an immune response because that’s the point of the shot, to activate your immune system so it’ll learn what to do if the real flu shows up.  But obviously there are 5 other viruses you can catch that will give you symptoms identical to the flu.

Do more people get sick now than a few years back?

More people on the planet means more people probably get sick.  But if we have a preventable disease and people choose not to prevent it (in themselves or their kids), then more people will start getting it (aka measles).  We had almost eradicated measles from the US until a larger group of people decided not to get their kids vaccinated, and now it has resurged.  Children worldwide die from measles, why would we want to put our own kids at that risk?

Despite the poorly matched vaccine in recent years, those that got the flu reported shorter duration and milder symptoms.

And obviously, the flu shot is not the only thing that is going to protect you from the flu this winter.

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