One Down, Nine to Go

One rotation down, nine more to go until I earn my Pharm.D. My first PY4 rotation took place at a small pharmacy located within a large clinic and adjacent to several other medical practices and a hospital. Despite this prime location, this particular pharmacy is *VERY* slow–they only fill around 30 prescriptions per day, compared to some major chains that fill over 500/day. The majority of these scripts are for trials of meds accompanied by coupons, which usually result in the patient going elsewhere in the future. I think this pharmacy has potential to be extremely prosperous and have a great impact on patient care–they just need to figure out how to promote themselves, their convenience, and their professional expertise.

Although this rotation started very slowly, I found plenty of ways to occupy my time and make the most of the rotation. I had the opportunity to participate in a great deal of compounding, everything from progesterone suppositories, to butt balm, to testosterone cream. I was also able to collaborate with physicians on occasion and assist in the care of patients.

One thing that did bother me was the number of drug reps that crowded this clinic. About every 4th person that walked into that clinic was a drug rep. As we all know, prescription drug costs can be astronomical, and therefore I am a huge proponent of generic drugs and make every attempt to save patients money. Don’t get me wrong, I support pharmaceutical research and appreciate the advancements that have been made. However, I can not justify a patient receiving, for example, an antihistamine that costs them $40, simply because it is a new isomer of an older drug, which would have only cost $10. I am especially critical of “me-too” drugs–those that are only slightly different yet cost two or three times the price.

During this rotation, I was able to see the influence that drug reps have over prescribers. The pharmacy and doctors’ offices were littered with pens and notepads and calendars branded with names of new drugs. Not to mention the daily drug rep-sponsored lunch that lured in the entire clinic to feast, only to open the way for the reps to pounce on them, touting why their new $80 blood pressure med was superior to the $4 beta-blocker that has been around (and effective) for decades.

Overall, the rotation was interesting. There was potential for much more, but I wasn’t too disappointed. Tomorrow I start my next rotation–Correctional Pharmacy Management. It is supposed to be a rotation centered around care of patients in the prison population, namely Kentucky’s major medical prison complex. I have already spoken to the student who just finished this rotation, and she seemed to be pleased with the projects that they undertook, and the hours. I would have to say that I am looking forward to this rotation the most–hopefully I won’t be disappointed. I will be sure to post my conclusion at the end of June.

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In other news, I had my stitches removed and I’m almost completely healed up. The final biopsy showed that they had removed all of the abnormal cells. So I am doing well and don’t even have to follow up with the dermatologist. Please take my advice and lather up the sunscreen this summer and try to avoid the tanning salons!

I’m Alive!

That’s right…I survived my surgery!

I go back in next Friday to have the stitches removed. They are also going to send this sample to the lab to make sure they removed all the abnormal cells.

Thanks for your support.

Update

I called the doctor’s office this morning to get more details on the biopsy. The report said I had an Atypical Melanocytic Nevus with Dysplasia. So basically an abnormal mole with cells that are abnormal and changing. So it is precancerous but not cancerous now–so I caught it early. I scheduled surgery for Monday afternoon. They will go in and remove more tissue, wider and deeper, under local anesthesia and I will need stitches. Thanks to all who have shown support. Thank you for your thoughts and prayer. I’ll let you know how it goes!

The Results Are In…

Well, after 4 weeks, I called again to see if my biopsy results were in. The message said “We received your pathology report today and you need to call our office to schedule an appointment for treatment.”

So I am pretty sure the tissue was cancerous and I have Malignant Melanoma. Not certain, but pretty sure. I plan to call the nurse in the morning and get some more detail and schedule an appointment. If it is, in fact, Melanoma, hopefully I caught it soon enough that it hasn’t spread and they can just cut some more tissue out. Hopefully the treatment wont be too extensive (or expensive) and my prognosis is good, which I am pretty sure of.

The moral of the story is…DON’T LAY IN THE TANNING BED! And if you have a mole anywhere on your body that has changed shape, color, size, or appearance, don’t be afraid to see a dermatologist and have it checked out. Take care of your body, protect yourself from the sun, and don’t lay in the tanning bed.

I will update you on the specifics when I find out more details.

Time For A Change

Almost 3 years ago I moved away from my family and friends in Virginia and came to Lexington, KY to start Pharmacy School at UK. Immediately following this transition, I quickly and efficiently started packing on the pounds. No, I wasn’t preparing for a famine, but merely making horrible choices regarding what I ate and how much. So now, here I am, 3 years older and about 30 pounds heavier. Yes, I have gained around 30 pounds since moving here. I am pretty sure that it all started with Totino’s Frozen Pizzas and half-gallons of Cookies & Cream Ice Cream–both of which are delicious, mind you. Then steadily over the last couple years my portions have gotten larger and my food choices have worsened. Nevertheless, I am now ready, at about 205 pounds, to make a change and shed these unwanted pounds. My goal is to lose at least 20 pounds and get down to 185 in 6 weeks (May 5).

So, last week I started to diet and exercise. My dad donated about 10 days worth of Nutrisystem meals. I was a little concerned about this food at first, as I thought it would be the most disgusting food that has ever touched my lips. But I’ve actually been quite pleased with most of the food (although Amanda would disagree). In fact, I would probably even buy 4 more weeks worth of it if it didn’t cost about $350. The lunch and dinner meals are decent, but the breakfast and snacks are lacking, most notably the Scrambled Eggs with Veggie Sausage (that begins as yellow flakes mixed with hot water and magically turns into Scrambled eggs and sausage) and Honey Mustard Pretzel sticks (do I have to say anything else?). But for lunch & dinner I’ve ate such meals as Vegetable Beef soup, Spicy Cajun Chicken and rice, lasagna, and even pizza. Even though the food may not look that good when prepared, it honestly doesn’t taste that bad. With Nutrisystem, you have 5 meals per day, mixing in fruits, vegetables, diary, and salads with the prepared meals, and drink at least 8 glasses of water. In addition to this, I have also been supplementing these meals with SlimFast Protein Snack Bars (which are tiny but actually pretty good) and sensible meals/snacks.

As far as exercise, I have been running about a mile everyday on the elliptical–sometimes I run further and sometimes twice a day. I also occasionally lift weights on the weight bench, something I need to start doing more often.

So over the last 10 days, I have done a pretty good job eating the required meals, including fruit (which I despise), drinking plenty of water, and exercising. Amanda also started dieting and exercising, so we are able to motivate one another and keeps tabs on each other’s progress and pitfalls. I lost 5 pounds in the first 5 days, and 8 pounds all together. If I can maintain this progress, I should be able to easily reach my goal. I am very proud of myself for sticking with this diet and actually getting results and am especially proud of Amanda for her motivation and weight loss. If you have any tips or suggestions, please let me know. I will keep you updated on my progress.