067

Today was my last day of community IPPE and it was so bittersweet. It is amazing how 160 hours have flown by so quickly yet so slowly at the same time. Even though it was my last day, Gregg wasn't even there. So I will have to drive back up to get my affidavit signed anyway. A Pacific alum named Chris was the RPh for the day. He had tattoos all over his arms and showed me pictures of his other tattoos on his chest too. If you could imagine what a pharmacist should look like, he definitely was not that.

Chris is quite the chatterbox as well. I am pretty sure he broke some sort of confidentiality while divulging his nephew's personal life to me who I so happen to know. When we weren't talking about pharmacy, our conversations dabbled in music, raising a family, religion, and Dr. Floriddia.

Even more impressive, I was able to have these conversations while filling AND making calls...LIKE A BOSS. I felt my last day was a good way to end my last days at the Laguna Blvd CVS. I will miss you Gregg, Gordon, Crystal, Carla, Ronish, and Cindy. You guys make an amazing pharmacy team and I have learned so much from all of you.

I will be heading into my geriatrics IPPE next semester which I am looking forward too but I know it will present its own unique challenges. My friend Daniel, who just finished his geriatrics IPPE, told me a depressing story on his last day. He was talking with one of the nurses and a patient comes in asking where his wife was. The nurse calmly replied, "Remember, she passed away?" He had forgotten that his wife has died just a few weeks before. That story just breaks my heart and I really hope I will have the strength to stay positive.

064

I am feeling much better now.

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I'm in pharmacy school and I would like to think I have matured a little since my days as a wee freshman in college. But some things don't change.

Last week I went into the pharmacy for the first time since midterms started and as I was doing the usual dispensing, consulting, and doing my intern thang, I pull out a label for Cialis. Awhile back, I wrote an entry on this prescription drug and I mentioned to Gregg how the first question he told me to research pertained to this drug. Not content to leave the conversation as it was, he told me to look up its duration of action and how often a patient can use this drug on my handy-dandy smartphone that I bought recently. After much scrambling, I managed to find the literature and report to him my answer.

As I was putting away baskets, he tells me, "You need to face reality".

Me: "...huh?"

Gregg: "Some people do it everyday".

Me:
Fortunately, I haven't had the opportunity to consult a patient on Cialis yet but I imagine I wouldn't be able to keep a straight face. I'm not trying to laugh at the poor guy's flaccidness or anything, I just don't think I have reached that level of maturity yet.

I then proceeded to have the most awkward conversation with my preceptor about drinking, clubbing, and sex. He also told me how I would be a bitter person by the time I reach his age as a pharmacist. I told him, "My spirit will never be crushed!" And then Gregg, being the ball of sunshine he is, tells me, "10 years from now, I am going to come to your pharmacy and poop on your counter and leave it there. Let's see if you'll be happy then"

Gregg, I will bag your poop and gladly consult you how to properly dispose of it.

062

The pharmacy was quite pleasant last Thursday and I had a very enjoyable and productive day. Gregg's task for me that day was to go through all the OTC aisles and write down every product I would recommend for certain disease states. It nearly took the entire day and I was overwhelmed by the sheer number of OTC and homeopathic remedies available. But it was definitely good to go through these products and now I can recommend ANY OTC! BUAHAHAH. I just need to go over the consultations and review their active ingredients...boo.

Back at school, I am taking an independent elective course that our group has lovingly called P.R.O.V.E: Pacific Rx Outreach Video Education (or something like that, we honestly just wanted a cool sounding acronym and everything else fell into place). The premise of the elective is to create patient education videos on drugs for certain disease states in a way that makes medical jargon make sense and show how your pharmacist is an awesome resource! Most importantly, we want to make these videos accessible to our patients who may not have the best health literacy so we plan on translating them in a variety of languages and focusing the videos on certain ethnic populations by incorporating familiar cultural aspects into our projects. ANYWAY, our first disease state we're tackling is diabetes and my job is the illustrator and finding information on glucose meters and test strips. So now this is where I tie in all the stuff I have been researching into the pharmacy setting...

The highlight of my most recent visit to the pharmacy was when I had finally reached the pharmacy counter to look up the diabetic meters and test strips. One of the techs was helping a customer in finding a lancet but instead, she was holding a glucose meter. She saw me, gave me a look of desperation, and left me there holding the glucose meter, my notebook, and a blank stare from the customer. In my head I was thinking, "Now is the the time to P.R.O.V.E my knowledge of diabetic devices!!!" Sure enough I explained to the patient what she was looking for and pointed her to the correct product. I felt like I was spewing rainbows because I was so glad to put my knowledge to use.

Bottom line: It feels good to help people.

061

Back in the pharmacy after a much needed and well-deserved break. To my surprise, I had a very good day because Gregg wasn’t there to ridicule and squash my self-esteem. In fact, it was very much the opposite today. Since Gregg is on vacation, a floater RPh came in to cover. He introduced himself as Gamal and instinctively I asked if he was Arabic and sure enough he is AND he added that he’s Egyptian! I think my eyes lighted up right there and then. Of course I shared with him how I went to Egypt the summer before and what I did there. Any free moment I had, I would drop as much Arabic I could member and Gamal would just laugh, I am pretty sure he was thinking, “who does this Asian girl think she is speaking my language?” I would like to think his incredulousness quickly turned into admiration because he even commented how good my accent was. Aaaw yeeyeaaah.

My ego inflated even more as the day progressed especially after this conversation.

RPh: On the phone talking to someone, “Yes, thank you Gameel” Hangs up the phone and turns to me, “Do you know what that means?”

Me: Gameel? Yah, it means beautiful.

RPh: I bet you got called that a lot while you were in Egypt.

I just laughed and this picture ran through my mind.

With my confidence reaching o infinity and beyond, I decided to be more assertive today. Whenever the tech would call for a consultation, I would just walk on over to the consultation window and do my intern thang. I was making calls like crazy while printing and filling. I was a multi-tasking machine. I had a new experience today too! AN ANGRY CUSTOMER! A customer called in today to see if we had an item in in stock. Unfortunately, I could not find his full list of prescription under the name he was providing me. I told him I would call him back because I was taking awhile (CVS computers are very slow). Even after searching and asking for help, I couldn’t find his prescription in the system. I called him back asking if he had called at a different pharmacy. With a huge exasperated sigh, he said “I’LL BE OVER IN TWO MINUTES”. At first I felt like an ant embracing its untimely demise under a large shoe but then I told myself, “NO, ANTOINETTE. YOU ARE DA BOMB TODAY!” Sure enough, in about 10 minutes, the customer came into the store and the tech calls my name, “Antoinette, you are being requested” I strut over (more like politely shuffle to the register) and offer my assistance to the customer. To make a long story short, he went by a different name in the system, the misunderstanding was resolved and we became best friends forever. He got his meds that he needed and he did not yell at me at all! The power of effective communication!

056

As of today, I have completed 76 hours of my IPPEs. I can't believe I have been interning for that long. Gregg still manages to make me feel like an imbecile but I had a good day at the pharmacy.

Answering patient questions and making recommendations are my favorite things to do in the pharmacy. Today, a mom and her son came in asking for a recommendation about itch cream. Apparently, the son had an awful rash in the crease of his arm from scratching it so often. The son refused to see a doctor and had been using neosporin to help with the itching but to no avail, the rash had gotten progressively worse. My initial thought was, "Why the hell are you using neosporin for a rash?" I directed them to the anti-itch cream and made some recommendations but made it a point to go see his doctor. Then he asked me if we carried witch hazel, which is normally used as an astringent for oozing rashes. He apparently heard from some magazine that it's good to treat baggy eyes. I stared at this self-conscious high school boy and then I stared at his prominent eye bags. I don't remember Bandy teaching us anything about baggy eyes but I recommended him to gently rub a soft toothbrush around his under-eyes to stimulate blood flow around his eyes to reduce the appearance of the bags and then I politely pointed him towards the direction of the cosmetics aisle to look for a concealer if he was really that concerned. Oh boys will be boys...

I also know what a yeast infection looks like now. After reconstituting an erythromycin cream for a patient, I asked Gregg to help me make those fancy swirls in the cream to make it look "pharmaceutically elegant" as he likes to put it and he bluntly tells me, "No matter what you do to that cream, it's still going to look like a yeast infection". I think I barfed in my mouth a little. I replied back, "I don't know what a yeast infection looks like." He responds by telling me that I'm a good girl and to be wary when I meet a dirty boy, lawlz. After looking at the cream, in my opinion, a yeast infection looks like cottage cheese.

053

Had a miserable time at IPPE's today. I don't know how my preceptor does it, but he manages to make me feel like a complete imbecile every single time. Gregg, despite your sour face and efforts to crush my spirit, I will still remain a happy little chipmunk. For Super Bowl Sunday, it was surprisingly busier than normal, but it wasn't too bad. Nothing really remarkable happened other than learning more about the CVS system.

I realized I really enjoy driving along I-5 up and down to and from Elk Grove. It's so straight and relaxing. I enjoy cranking up my radio and singing out loud. Such a pleasant 45 minutes lost in my own thoughts.

Since it is Super Bowl Sunday, I managed to arrive in time for the closing ceremony as the field exploded into confetti. I was rooting for the Packers, but I secretly wanted the Steelers to win because of that "Black and Yellow" song. This coming week, the weather is going to be sunny. Such a nice change from the doom and gloom of last week. Necesito estudiar ahora!

052

There is a new pharmacist at the pharmacy I am interning at. His name is Brendan. He is from Massachusetts. Recently moved to California this past summer. 24. And has beeeeaaautiful eyelashes that I envy lol He is so incredibly chill. I always ask myself, "Why isn't Gregg more relaxed? Why does he always have to look at me like 'Are you seriously going to do that'?" I guess it's because Brendan is still young and hasn't been jaded by the world and the evils of CVS that Gregg so vehemently spits upon and reminds me about every time I am working with him.

I actually like the CVS system of scanning and inventory checking. It is a hella efficient. More so than the out-patient pharmacy that I volunteered at last year. Yes, the system does not help the patient-pharmacist relationship at all but I can see the system improving. I HAVE HOPE!

Somehow, I managed to gash the space between my thumb and pointer with a dispensing spatula while I was dispensing prescriptions today. What idiot does that? Oh me. Did a consultation, made phone calls galore, restocked, found out all the clerks are all older than me when I thought they were all younger than me. Dude, I would be so lost without the techs. I wish I had a shirt that says "I <3 PharmTechs" to show my appreciation for them. First time I left exactly at closing time. I didn't know what to do with myself, except go home.

Another day of work tomorrow. I'll be missing the Super Bowl with the Boy's Club. I hope they save me food.

050

The convenient thing about keeping a blog about my life, pharmacy experience, and everything in between is that I am required to turn in a reflection about my IPPE experience once I am done with my 80 hours this semester. Today marks my 30th hour of pharmacy experience. Gregg was not present so I felt much more relaxed. Gordon was the pharmacist for today and I realize he is much more of a pleasant person to be around. I did a consultation, made lots of phone calls, and dispensed for most of the day. So nice and relaxing. I feel like I am learning the intricacies of the CVS system better. Learned that Gordon is Mormon. He also played basketball and football in high school.

I'm getting over my paranoia of making phone calls to patients. Now that I actually know how to use the computers, there's less fear of sounding like an idiot on the phone.

At CVS, they have continuing education for the pharmacists almost every two months. Gordon didn't seem too pleased to be doing it during the slow hours.

My eyes get really dry after working a full 8 hours. Also, my car hydroplaned off the freeway entrance and my right headlight is totally blown out along with some ugly scratches on the nose of my car. It didn't help that the car kept making suspicious noises throughout the 30+ mile drive and my phone battery died. Sad times.

045

My preceptor's name at my IPPE site is Gregg. Note the extra "g" at the end of his name. I guess his parents wanted to be original by adding an extra letter. It must be annoying correcting people when they mispell Gregg as Greg. When I see the name "Gregg", all I think of is an angry egg. GRRRRR-egg.

-----> edit

On my second day of interning, my preceptor asked me a PK question: "Out of the three male erectile dysfunctional (ED) drugs, which one has the greatest bioavailability and half life?" Out of Viagra, Levitra, and Cialis, Cialis is the winner with a half life of up to 17.5 hours. It's effects can last up to 36 hours! I even filled Cialis today in the pharmacy. Amazing.

044

Yesterday I gave my first consultation at the pharmacy. It was a prescription for amoxicillin for a little boy named Jameson. After I went through the consult, he cutely and politely said, "Thank you!" I think I just melted right there because I felt I made a difference in the world. Haha. It was a long 8 hour day. My preceptor got me to do reconstitutions, consultations, filling, answering OTC questions and galore. He gave me some homework to do too. Out of the three erectile dysfunction treatments (Cialis, Levitra, and Viagra), which one has the greatest bioavailability and longest half life? I've only had 6 classes of pharmacokinetics since the semester started and we just started talking about drug elimination and distribution. I feel stupid most of the time because of my lack of working in a pharmacy experience but I have a feeling I will be learning so much from my preceptor.

I've also noticed that my comics are slowly showing more personality than the usual formless blobmen that I draw. Hurray for creativity!