Wednesday, November 17, 2010

Next time I post I'll prolly be married

Let's skip the traditional apologies for lack of posting and just get on with it:

1. Wedding is in less than a month. People keep asking me how I feel and I always respond "I'm ready for marriage but I'm not ready for the wedding." Planning and preparation for this whole shindig has been a high-stress nightmare and I've only put in a fraction the effort Meg has put in, so make sure you let her know how wonderful everything looks. In real life, planning a wedding is not anything like the Hollywood version which is usually a 90 second montage of sniffing flowers and eating cake and being filled with glee. I'm just ready for everything to be taken care of and be able to relax and enjoy the day and move forward with life and a wife.
Thankfully we have a hell of a way to relax once everything is done (Jamaica, whooooo!) and I think we are deservedly spoiling ourselves on the honeymoon.

Can we all still be friends even after I'm the "weird old married guy"? I worry at times that our friends won't know how to deal with us socially once we're married... we can still be fun, individually or together, so don't be scared of us, please.

2. Work/school/career-wise: still totally obsessed with nuclear pharmacy as a new career path. I finished my Cardinal rotation and then did a very hands-on rotation at the OSU nuclear pharmacy in September, and they confirmed what I want to do. Unfortunately it's a very small niche practice with a low turnover rate, so chances were always against me to start in it, especially since I don't want to move. I've spent a lot of time trying to become super-best-friends with a professor at OSU who is practically the nuclear pharmacy guru for the eastern half of the US and he keeps me informed of any opportunities in the field.
I went ahead and accepted the CVS offer because I don't think anything will open up in nuclear in the next year around Columbus and because they offered me a boatload of money, and it's only a 1-year commitment. If something magical happens and I get an offer in nuclear, I can get out of CVS by paying back the bonus they gave me for committing... which seems easy except we already spent every penny of that bonus an wedding/house/life needs.

3. Pharmacy rotations aren't too bad... I apparently have a knack for picking rotations that aren't too demanding. Currently I'm pretending to be a clinical pharmacist at OSU's family medicine office, and it is more interesting than I thought it would be. There's a lot of interaction with patients and physicians and I'm being forced to remember a bunch of stuff I needed to review for the licensing exam anyway. Stupid/unmotivated patients are extremely frustrating, but it definitely provides insight as to the inability of the average American to take care of themselves.
One funny story so far:
If I'm being told a patient's medical history/complaints before I go in to talk to the patient, you would think that SOMEBODY WOULD MENTION THE PATIENT IS DEAF. So I go in, introduce myself, dude seems shy and introverted, and I start rambling for a good minute and a half about his meds and asking how he's feeling. So after I get done with my spiel, he tilts his head in the classic quizzical manner, and then starts throwing some serious rapid-fire ASL at me. I hope he couldn't read lips, because despite my background as a scholar and a gentleman, my next spoken words were definitely "Ohhhhhh fuck."
I then politely excused myself (read: after cursing and instantly breaking into a full-body sweat, I mumbled something, did what I hoped was interpreted as a "hold on a minute" gesture, and scooted out of the room at 90 mph) and proceeded to patiently inquire the staff as to what the hell I was supposed to be doing. Eventually they brought in a webcam and monitor and we connected to the interpreter's service for OSU and had ourselves a very awkward and halting conversation.

Afterwards I was left to wonder - is it more embarrassing to be the patient and have to make the signs to a 60 year-old female ASL interpreter on a webcam that you have "groin pain"? Or is it more embarrassing to be the interpreter who has to see the signs and then announce to the anything-but-mature 24 year-old pharmacy student "I think he's trying to say his groin hurts" and then watch him try desperately not to laugh in front of the patient?

Tuesday, August 10, 2010

Rotations rotations rotations

Decided it was time for another life update for my faithful readers.
Mostly just going to discuss my pharmacy life for now... I hope to get another post up soon about moving back to Westerville and other general life updates.


So I have finished my first rotation and am a week and a half through my second one. The first was the month of June spent at the Apothecary Shop, a specialty/compounding pharmacy down in the Arena District.

High lights- Laid back atmosphere, they compounded some cool things like specialty capsules, lozenges, creams/ointments/gels, and had a clean room for injectables (including intraocular injections - stick a needle in your eye?), nice people to work with and easy hours. Also, being a specialty pharmacy, their clientele was way different from my usual; sexual health (including lots of transgenders), pain management (the *nice* addicts, not the crazy ones), HIV/AIDS patients, veterinary stuff (I made tablets using "Grilled Tuna" flavoring oils), and so on.

Low points- They didn't have much organized for me to do. I ended up mostly being free production labor for them and I didn't learn anything new after the first week there. It got really boring/tedious/frustrating because it ended up being a waste of my time and I think they used me more as free help than actually focusing on the fact that I was a student with an honest interest in their work.

Outcome- It was interesting for a little bit but ultimately disheartening. I can cross off compounding-pharmacist as a career path because the pharmacist himself is never involved with the actual production of the cool dosage forms besides quality control and verification; the production aspect was the only interesting thing to me. I definitely got some new experiences: custom-making cherry steroid lozenges for a transgender patients (was it James or Jamie, now, sir/maam?), working for a small independent as opposed to my current mega corporation, and working in a lower volume store.

Currently I am at Cardinal Health for the rest of August. It is kind of a combined rotation to expose me to both the corporate side of running a pharmacy business and also to introduce me to nuclear pharmacy.
Unfortunately/fortunately, I am starting to fall desperately in love with nuclear pharmacy. Everything they do is just so much cooler, and it is a field that actually applies some of the 5 years of science stuffed down my throat. There is something massively appealing to me about this practice: understanding of nuclear physics and decay, radiation and how to use it in diagnostics/therapy and shielding/reducing exposure, the pharmacokinetics and biochemistry (how the drug is absorbed, distributed, metabolized, and eliminated from the body and the tissues it tends to perfuse more readily), and just the sheer badass factor.
My preceptor for the month is in the Quality and Regulatory department at the corporate office, so it has been interesting to hear from her all the crazy things that can go wrong and also to understand the reasoning behind the production process/safety issues. She is also the most nice/bubbly/energetic person in the world with a true passion for teaching anybody interested in becoming a "Nuke", as she calls it. So far I've got to play (and by play, I mean watch somebody else work on something while being terrified I was going to turn into a mutant from radiation) with a particle accelerator/cyclotron where they create radioactive materials, using the robot arms to manipulate RAM (radioactive materials) in the "Hot box"- which is basically a sterile vault encased in 3 feet of lead shielding, sit in on the error/safety correction team's meetings, work on supply chain issues (there are only 3 nuclear reactors in the world qualified to create the specific nuclear material needed for medical use, and right now 2 of them are off-line, so it's been interesting to see how they stretch out the material they can get their hands on), and also get to see a big overall picture of corporate life by meeting "all the paper pushers in this massive bureaucracy." I get to meet people in charge of the different operations teams here at Cardinal, including the head marketing director, operations director, and the president of the entire nuclear pharmacy division which amounts to about 70 pharmacy sites and 30 cyclotron sites across the country (wearing a suit to that meeting!)

Anyways, I be ramblin'.
Highlights- NEAT! (as mentioned above), no dealing with snobby customers/ruthless insurance companies, more interaction with healthcare professionals like radiologists, nuclear medicine technologists, PET technicians, chemical engineers/chemists, and most satisfying so far- utilization of Mr. expensively-educated-brain in my head.

Low points- Awful, awful hours for your average nuclear pharmacist (typically something like 3am-11am, plus being on call), no openings (at least at Cardinal's sites) in the Columbus area, and I didn't expect to like it SO much and therefore this rotation is making me really question the official "5 year plan" I had figured out in my head for going down the CVS career path.

Outcome- I don't know yet. I have another 2 weeks here and then I will start a new rotation of more practical/hands on work at the OSU nuclear pharmacy next month. I am waiting to see if my infatuation with nuclear pharmacy waxes or wanes as I get into the practical, everyday work of it over the next 6 weeks, and then I will have to seriously analyze where I'm going with my life. Stress. I am extremely happy that I bent over backwards to get these two nuclear pharmacy rotations because I have finally found a field that I may very well have fallen in love with, but it's a much messier career path. If I turn down the CVS offer (which I have to reply to by November), I have no guarantee of a job at all, and if I do get a nuke position it probably won't be local due to the low turnover rate, and I really really don't want to move away from my beloved Columbus. The hours are a real challenge to normal life functions as well. Lots to consider...

Monday, May 17, 2010

Life updateas

People are always stopping me on the street and asking me, "Jakeysaurus Rx, I understand that you're due for 6 years of school, yet here you are nearing the end of the 5th year and keep talking about 'no more tests' and 'rotation' nonsense. Please inform us of your life plans!"
Well, people on the street, I am here to inform.

I am 3 weeks away from being done with my 5th total year of college. This is, however, only the end of the 3rd year in the actual Pharm.D. program. My first two years was strictly undergrad/prerequisites. So I know I confuse a lot of people when I talk about my "4th year rotations" regarding my last year in the Pharm.D. program which is actually my 6th total year in school.

Basically = blah blah blah here's what I'm doing from now on:

To get licensed in the glorious state of Ohio (and there is NO state more glorious-er) you are required to have 1500 hours of experience/intern hours under the direct supervision of a licensed pharmacist. The college of pharmacy was tired of their silly graduates not getting this requirement done on their own, and since the Pharm.D. program was started, the final (4th) year of the program was designed to get students the vast majority of these hours and expose them to a good variety of pharmaceutical practices. As the hours required to get licensed have increased (previously 1200), the number of months required by the college has gone up.

They now require me to complete nine month-long rotations in the 11 month period from July 2010 to May 2011. There are certain requirements regarding months needed in hospital or outpatient settings, etc.

The conditions required to complete each rotation varies. Some pharmacists will simply teach you and plug you in as if you were filling their role for the day, other pharmacists will have you do research/projects/community events; it varies a lot from one to the next.
The only consistent, unalterable, and sucky condition: each rotation must add up to 168 hours in a month, which means that I will contribute on average 42 hours of unpaid labor every week for 9 out of the next 11 months. Great.

To figure out where I'd be going next year, I had to go through a process that involved my scouring over 800 preceptors (preceptors is our fancy word for a pharmacist that agrees to take on a pharmacy student but not pay them) to check their availability, put together a massive grid of possibilities and backup schedules, and then putting together my ideal schedule and submitting it to the college; and then they send me back their ideal schedule for me which strangely enough, didn't look anything like the one I submitted. After a few weeks of negotiating, trading, and begging, here is the final schedule for my last year in pharmacy school:

July 2010- The Apothecary Shop - This is a specialty compounding pharmacy in Columbus. They do the fun manipulations of drugs that we can only pretend we're capable of at CVS. A couple common examples:
1. A patient is allergic to a dye used in a name-brand drug and no other formulations are commercially available. We can compound tablets/capsules/solutions with the active ingredient but without the allergen.
2. A pediatric patient refuses to take a nasty-tasting but totally necessary medicine: we can take their medicine and turn it into a lollipop, popsicle, all sorts of fun things.
This was one of my first choice rotations because I always like to construct things, this satiates my desire to have a mad scientist setup involving bubbling beakers and crazy devices on a lab bench, and you know the patients actually value your service (because coming to this place is expensive, rarely covered by insurance, and not down the usual beaten path for patients to get their meds)

August 2010 - Cardinal Health Division of Nuclear Pharmacy - I will be working at Cardinal in Dublin down in the 5-stories-underground nuclear pharmacy (it only sounds dangerous.) This has always been a fascinating field for me and a definite career interest. An excellent description of what the heck nuclear pharmacy is can be found here: http://nuclear.pharmacy.purdue.edu/what.php
It's great that I got assigned to Cardinal because they do the radiopharmaceuticals for the majority of the hospitals around here, and thus, are the most likely nuclear pharmacy to hire me due to their massive size. Gotta bring my A-game to this rotation.
I mean, how cool would it be when people ask what you do and you say "Nuclear ". Nuclear adds respect points to any job title.

September 2010 - Ohio State University Medical Center - Division of Nuclear Pharmacy - More of the same, though I think this will be more hands-on and about the daily radiopharmaceutical dispensing routine while the Cardinal preceptor would be more on the business/logistics side. Still, since I'm very interested in this specialty, it's definitely good to get as much exposure (experience exposure, not radiation exposure) in this field as possible.

That's just the first 3 of 9 rotations I'll be doing. I realize this entry has already become quite verbose and I'll write about the remaining rotations as they come up.

Want to know what sucks? I need 1500 hours to sit for the board exams... I already have over 2300 working at CVS. There is no legal need for me to do any of these rotations, I only have to because they are set in stone as part of OSU's degree program. Bleh. I would spell out the totally unnecessary financial hit this entails but it's too depressing to put the numbers down in writing.

Speaking of my expansive time at CVS, they have started to woo me. They brought me, and the other ~10 students in my class that have worked for them through school, to a fancy seafood dinner and started luring us in with the big dollar signs. I'm glad I shaved and got dressed up for the event because my boss's boss and my boss's boss's boss were there. We filled out forms about where we hope to practice after we get licensed and we were told we'll be getting offer letters in September. I already know my boss (squared) and boss (cubed) like me and want to keep me in their district/region and they said they anticipate having an opening for me.

So, basically I got to eat fancy salmon on their dime and was told I'd be getting a high-paying job in the area I've lived for 22 years. If this is how you woo me, CVS, keep it coming.

Wednesday, April 28, 2010

"Volunteer" hours

I wrapped up my "Community Health Volunteer" hours today with a Central Ohio Diabetes Association screening and education event at the Ohio Family Opportunity Center on the south side.

I know George Carlin beat the subject to death, but the fluffy language bothers me, so let's translate the above:

I finished my required service hours for school by poking fat people in their fingers, telling them their body can no longer compensate for the Dunkin Donuts floating through their blood vessels, and then they picked up their food stamps while their squealing bastard children ran rampant around our booth. I assume they probably then went out and got more STDs and/or Dunkin Donuts. I then came home and tried to wash as much depression-stink and HIV off of me as possible.

I love society... especially when I get to "Serve the underserved!"

One highlight: Explaining to a middle-aged woman in front of her daughter what erectile dysfunction means.
She then turns to daughter and tries to explain it as, "You know, the penis doesn't get long, and grow..." and the daughter clarifies, "You mean his dick can't get hard?"

Friday, April 9, 2010

Resumes

The wifey is polishing up her resume and letting me give her useless advice, and I realized that I haven't touched my resume since I started grad school. So I pulled up "Jake Resume 2007.doc" to see how hilariously inappropriate it presently is.

Some highlights include:

- My "Work Experience" still lists The Buckle at Easton - - - despite the vast educational/experential benefit of a 4-month stint putting security tags on jeans in 2004, I think we can safely remove it

- Boasting of my EAP (Early Admission Pathway) to the CoP... totally inconsequential now that I am actually IN the CoP

- I should probably mention that I have a college degree somewhere in the updated version

- Still listed as a CVS/Pharmacy "Pharmacy Service Associate/ Technician"... I can now simplify that to "Intern / Person who gets all the shit dumped on him"

- About 25% of the 1-page resume is still dedicated to ye olden days of high school glory. This is obviously the funniest part to read now.
This will be tough to cut (though I understand the absolute necessity to purge HS accomplishments from 5 to 8 years ago) because I think out of all my life eras, I was most impressive among my peers as a high school senior. Old version of the resume still includes: HS GPA, graduating rank, ACT score, National Honors Society, Scholar-Athlete awards, blah blah blah.

- Think I can still convince somebody to hire me because I was 1st team all-Ohio and captain of the lacrosse team? "2007 Jake Resume.doc" sure thought it was pertinent information. This is crushing to remove because I don't get nearly enough chances to subtly mention that I was indeed a total lacrosse stud. I repeat, I don't get to mention enough that I was 1st team all-state and a man among boys. I reiterate that there aren't enough opportunities in everyday life to inform people I was FIRST TEAM ALL-OHIO without sounding, you know, like I'm bragging.

- I just can't do it anymore... I've tried to bullshit it long enough, but I think it's time to admit that my Spanish-speaking skills no longer be listed as "Proficient". Although I can still tell people to "Tome un tableta por la boca tres veces al dia" si lo necesite. Ole!

At least "2007 Jake Resume.doc" is lightyears ahead of "2004 Jake Resume 2.0.doc" which still contained these resume-boosting nuggets:

Co-founder and Parliamentary officer, British Club

Advanced snowboarder, WNHS Ski Club


Oh British Club...

Wednesday, March 10, 2010

I feel old

Today is a day of feeling old.

About 15 months ago, my oldest brother lovingly pointed out a gray hair on my head. Okay, one gray hair, maybe that particular melanocyte had a bad reaction to Mr. Pert Plus and decided this particular hair was going sans pigment from here on out. One hair... sad but manageable.

Today I'm cruising along down to campus, on a day I don't even have class, to go to the library to study for a test that's well over 72 hours away. Clearly I am already behaving like a 70-year old, but what shook me out of my denial was looking in the rear-view mirror and wondering, "Where the fuck is my hair?"

Yes, ladies and gentleman, the hairline has started its inexorable march... towards the back of my neck. I haven't even hit the quarter century mark but Team Hair Follicles is throwing in the towel.

So the rest of the day was spent reveling in my now well earned right to be a cantankerous old grouch. Once I get to the library, everybody was talking too loud. We're in a library, people... Betty Blabbermouth, just because you aren't sitting at a desk doesn't mean you can bitch on and on with your friend Sally Stupidbitch about Jonny Jerkhole at the party last night. Last night was a Tuesday night, and you should've been in bed by 11 pm like the rest of us. (WHY HAS SPELLCHECKER WAITED 23 YEARS TO TELL ME THAT SHOULD'VE IS NOT A PROPER CONJUNCTION? I USE IT ALL THE TIME. IT MAKES FUCKING SENSE TO ME... SHOULD HAVE = SHOULD'VE. I HEREBY PROMOTE IT FROM COLLOQUIALISM TO PROPER ENGLISH, AND LOOK FORWARD TO SNEERING THE NEXT TIME SPELLCHECKER TRIES TO USE THAT RED UNDERLINE BULLSHIT ON ME.)

Anyways, by the "rest of us", I mean people like me that can't understand why our neighbors play loud music past 7 in the evening or why there's such a bright streetlight directly outside my bedroom window. If you get in the way of my nightly 7+ hours of sleep, you are liable for any crimes of passion I commit the ensuing day.

Back to the library. I am tolerating the loud stupid sluts as best I can. I am powering through oncology chemotherapeutics like the obsessive peRPhectionist I am. (I can't express how clever I think I am for just now coming up with peRPhectionist).

I need to take a break, so off to the bathroom I go. Oh hello, I guess this Asian dude is washing his hair in here. I mean, I'm all for the multifunctional sink use but... How long have you been here that you feel this is necessary? From my little fortress of solitude I suddenly hear the unmistakable sound of a vigorous tooth brushing. I chuckle as I hope his minty Aquafresh mixes well with the cologne-esque (colon-esque?) fumes from the giant poo I am taking 10 feet away from him. Take a whiff of this, stupid eternal resident of the library; I am old and cranky and you will bear the burden of my wrath.

Back to the private study desks after my private act of bioterrorism. I'm thinking I can put in a few more hours, until I look out the window. From this building and at this angle, there is probably the only unobstructed view longer than a half-mile on any place on campus, and at the farthest reaches of my horrible eyesight, I see the turf fields beside the rec center bathed in the cool glow of stadium lights. The club lacrosse team is practicing and with the encroaching nighttime darkness the field literally looks like the light at the end of a tunnel. A tunnel of pharmaceutical sadness.

I am looking down at this with what can only be described as a wistful yearning to be down there. Then I realize, how old must I be to be looking at anything "wistfully"? I actually even stop and think about how good it was when I could keep up with "those young guys"... who are at most 1 to 4 years younger than me. I suddenly realize that while I act like a geezer and may be a few follicles down from 3 years ago when all this pharmacy nonsense started, it's pretty much all in my head. I've let my self-identity decay into this learned helplessness of thinking I'm too old or too tired or too busy to do those sort of things anymore. While I enjoy being cranky and sassy with the young'uns, I realize I need to let myself act and feel young every once in awhile.

So I came home and played fetch with Guinness, then I whined to Megan about going bald. She tried to make me feel better by showing me wedding photography (she's got gigabytes of research on this stuff) with plenty of slightly balding grooms who still managed to look reasonably handsome.

Blah blah blah. I've gotten off topic, obviously, but the point is I'm going to try to think and feel younger. I've temporarily let pharm school turn me into an old crotchety man, but no more. Tomorrow I'm back to being 23 years young, and try to keep this mid-life crisis from relapsing for at least another 20 years.

Wednesday, March 3, 2010

This is the sort of thing that terrifies me:
http://abcnews.go.com/Blotter/walgreens-told-pay-285-mil-teen-pharmacy-techs/story?id=9977262&page=1

If you're too lazy to read the story:
1. Young, likely-undertrained pharmacy technician makes an error in data entry of a prescription
2. Very bad error is not caught by pharmacist, terrible therapeutic consequences ensue that contribute to eventual death of patient
3. Lawsuit leading to 26 million dollar judgment against Walgreens

Yikes. Let me first explain that the most terrifying thing about this is that somebody got harmed to such a degree, and also because it happened due to a mistake at both the tech and pharmacist level. That's something to be sad about and sympathetic for the family.

What is unsettling about this is the massive judgment. I do understand that damages were done, massive medical costs were likely incurred, that a life was lost due to the error, that there is emotional damage done to the family that you can't put a price tag on. I agree that there should be some sort of compensation for the error; but for a jury to find for and an appeals court to uphold a 26 million dollar judgment sounds a bit extreme to me.

On a selfish-professional level, I am happy that they didn't go for the throat of the tech/pharmacist responsible and instead went after the corporation. I have never worked for Walgreens but from what I've heard, they do the exact same BS stuff that all other retail pharmacies have been forced to do lately: Cut the workforce hours, which leads to a dangerous working environment. A overworked/understaffed/undertrained pharmacy WILL lead to errors.

I work at a certain major competitor of Walgreens so I figure the trends are pretty similar. Here's how things have changed:
Work environment when Jakeysaurus Rx hatched into retail pharmacy, circa November 2006:
Script volume: ~350-400 on a weekday
(Day) pharmacist hours: 120 a week (3 full-time)
Technician hours: Typically 7 techs on full shifts (8 hour shifts) per weekday

Work environment as Jakeysaurus Rx slowly goes extinct from retail burnout, circa March 2010:
Script volume: 450-500 on a weekday (can be up to ~550 on some Mondays)
(Day) pharmacist hours: ~88 a week (2 full-time, 1 floater with a few hours on occasion)
Technician hours: 6 techs on Mondays, 5 techs most other weekdays

Basically, a huge increase in volume (up to 25% more prescriptions per day than when I started), with 2/3 the pharmacists and 2 fewer techs every day. ERRORS WILL OCCUR.

Why has this happened? I like to blame the Giant Eagle/Walmart bastardization of pharmacy. Their 4-dollar programs, free antibiotics, $25 transfer coupons... yeah they all seem great to the consumer, and they're bunches of fun in the short term. But it changes pharmacy from a once-proud healthcare industry into a competition to shove as many pills into bottles as possible in the fastest and cheapest possible manner.

It makes me sad that just 3 years ago there was no such thing as a damn pharmacy promotional program; there seems to be a new ridiculous thing every week. Due to the need to stay competitive, we are now slaves to all the latest price-cutting, quality-reducing, and stress-inducing "great corporate promotions". And though patients will never see their connection to it, they are the ones that get harmed in the end by the consequences of pharmacy on the cheap.

Sunday, February 14, 2010

Love is in the air....

This was the first time I've ever had to work on Valentine's Day, and let me tell you: the condom business was a-boomin'. There were also fewer complaints than usual about the cost of Viagra and Cialis, in the truest spirit of romance.

Bonus highlight of the day: A man comes to the pick-up window and states, "I need to get my baby momma's prenatal vitamins." So much love this time of year.