Friday, June 8, 2012

A conversation with a pharmacist


I walked into the front doors of the Med Ex pharmacy for the first time in my life that Wednesday. What had once been a well regarded Mexican restaurant had been leveled and rebuilt to be the latest addition to the chain of discount drug stores. I wondered as I walked in the door where I was standing in relation to the tables and chairs my family used to frequent, but my thoughts wandered only briefly. I was already tired, more so that I needed to be, and I was already feeling the effects of seven hours worth of chemotherapy working its way through my blood. Drugs with names too long to remember and side effects that sounded more like chemical weapons that anything therapeutic hung in the back of my mind as I made my way to the back of the store.

A college aged tech met me at the counter with a big smile. "How can I help you?"

"Hi, I spoke with a woman just a few minutes ago about a prescription that the Wal-Mart Pharmacy couldn't fill."

"Ah, yes. That would be our pharmacist. She's with another customer right at the moment" He pointed towards the shelves that dominated the middle of the store and concealed anyone from view. "Can I help you?"

I explained my situation in brief;  a day of chemotherapy that had run long, a list of prescriptions that needed to be filled, and finally arriving at Wal-Mart only to find out that they couldn't fill the most critical of the orders, Phenergan gel, a topical anti-nausea drug any my only hope for keeping my stomach under control for the next few days. I was tired, sore, and more than a little scared. My first round of chemo had led to a week of torturous side effects that I wasn't looking forward to again. I wasn't just scared of the side effects, I was frankly dreading every second that brought me closer to the next morning and the unknown.

The clerk took my insurance card and my information with an understanding nod and a friendly smile. He wasn't just being polite though, I could see in his eyes the want to sympathize, and the need to get the job done. I didn't come there to be felt sorry for, and the best thing he could do was set everything up for the pharmacist's stamp when she got back.

A short time later a girl who didn't look any older than twenty-five and not taller than five foot four emerged from the maze of shelves, clad in a white lab coat. The clerk pointed her at me, and I did my introductions yet again. I was glad for the conversation. Talking took my mind off of the worry I was feeling. Her name was Melissa, and in one well-practiced schpiel I unloaded, yet again, my uncomfortable situation on her shoulders.

She went to work on filling the order at hand, again understanding that her job was the best thing she could do for me. I could see the energy in her eyes, youth doing its best to combat something as ugly as cancer, and frankly doing a good job of it.

Then, with the order halfway filled, I chanced a random idea.

"Actually, I have a question for you."

"Oh?"

"One of the nurses today said that my symptoms sound like one of the drugs might be causing my stomach to over produce stomach acids. Do you know of any over the counter drugs that could help me fight that?"

Melissa bit her bottom lip and leveled a worried look at me. "I'd love to help you, but I'm really scared of recommending anything without knowing what medications you're on." She shrugged a silent apology, clearly hating that she had to say that to a man whose only wish at the moment was some measure of comfort in the days to come. But I didn't dare blame her; of course she was cautious, that was her job, that was what she went to school for.  Good intentions didn't amount to anything when someone accidently gave themselves a heart attack or kidney failure because two drugs didn't play well together.

But I wasn't done, and I wasn't about to give up. The devil was in the details, and I had been paying attention.

"What if I could tell you all the drugs they gave me?"

She blinked. "Can you remember all of those names?"

"Sort of. Do you remember the CHOP R treatment protocol?"

She winced again. "Um… maybe? I think we studied it once in pharmacy school."

"That's okay. I think it's on Wikipedia, and I'll recognize the names if you say them."

And then, just like that the process took off. Suddenly we weren't just two strangers with a chance meeting. We were happenstance allies with a goal, a challenge, and  tools to use. For twenty minutes she stood on her side of the counter and I leaned on mine as she went line by line through the list of five drugs and checked them against no less than three different pharmaceutical databases, carefully taking note of any listed conflicts they might have. She read off the lists of medications, and item by item I confirmed each one, remembering the name from many lengthy conversations had about them.

It's easily now to look back and think of that time as boring. But it wasn't. it was fascinating to watch her work. Her hands flew over the keyboard, her lips formed half-spoke words as my ears heard bits and pieces of sentences said to no one. She asked questions, made jokes, we even talked about movies, but the whole time she was still also intently studying her screen like her life depending on it.

Then it hit me, it wasn't her life she was worried about. It was mine.

Eight thirty at night on a Wednesday with clear skies and warm weather, miles from any hospital or ER, and I was looking at someone who's next few decisions could very well ease, or endanger my very life.

"Here, I think I know what you need." She finally said, and lead me to the same shelves that had swallowed her up before my arrival. She didn't just walk up and hand me a box of pills like I had seen elsewhere many times. She pointed out name brands, and generics, discussed the differences and similarities, and even pointed out one drug and said "Whatever you do, don't get that one."

"Oh?"

"I didn't see it listed as conflicting with any of your drugs, but it does conflict with a host of other ones. In fact, there's still a big fight going on with the FDA about whether or not it should be over the counter or not. On paper, its technically safe for you to take, but on the off chance you forgot a drug in that list you gave me, I'm just recommending that you play it safe."

"No argument from me." I said. I recalled not a day before  telling a customer  to go ahead and 'play it safe' and spend  an extra seventy-five bucks on an external hard drive. All of his data was on his computer, a backup would help make sure that all of his small business's files didn't vanish with a single hard drive failure.

Now, here was this girl, easily five years my junior, telling me to spend an extra three bucks so that I didn't wind up in the hospital, or worse.

I picked up the recommended items, and the clerk at the pharmacy desk rang me out with a smile and best wishes.

When you study history like I do, specifically military history, one of the most common themes is strangers meeting  for brief moments of time to aid in a common cause. The infantryman from Nebraska who's mission suddenly depends on the cobalt engineer from Pennsylvania. The radioman from some small town in New Jersey who is suddenly the only way for a West Point educated general to finished what he started. The young, the old, the different, the similar. When faced with challenges, those who are willing to accept them will stand side by side, even if only for a moment, and do what they can before the necessary departures have to be made.

That night, Melissa and I stood shoulder to shoulder, and for a brief moment she was my council, my guide in that one moment of my fight against cancer. She did what she was trained to do, and watched me walk out the door, probably no more certain than I was that my next few days would be any better than their counterparts three weeks before.

That was two days ago.

The second dayfollowing my first chemotherapy treatment was hell, with my stomach hell-bent on torturing me beyond reason, and without mercy.

I just got home from work today, after pulling a full shift, and overtime. Full work load with no help or relief given, or asked for. I walked in there armed with the lessons of my first experience, and the advice of a good pharmacist.

And by God, I made it through that day with my head held high, and an honest, earnest, sincere smile on my face.

I'm no longer scared of what tomorrow brings.

In fact, I looking it in the proverbial eye and saying "lets see what you've got!"

6 comments:

  1. I predict you will be seeing Melissa again..nay- frequently!

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  2. What have you got to be afraid of? Let's go back to High School for a moment... We've stood side by side. You've got this! You'll beat this because you don't know any better ;)

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  3. Awesome story! It is good to hear stories about people who car e and try to do the right thing and do it because they feel it from their soul.

    As a side note if your current nausea meds don't work well enough, if you haven't tried it already, I highly recommend checking into ZOFRAN and see if you can take that! My experience with Zofran is it completely eliminates the most GUT WRENCHING I think and wish I could die it is so bad nausea.

    http://cancer.emedtv.com/zofran/zofran-generic.html

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  4. I second the Zofran. It was specifically designed for cancer patients, and did exactly what Phenergan and literally a dozen other drugs had failed - badly - to do.

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  5. Jodi, Ontario, CanadaJune 11, 2012 at 8:07 PM

    So glad to see you posting again. :)

    You should take the time to send an email to the company Melissa works with to share the amazing care and help she gave you. She deserves the recognition.

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  6. A really lovely thoughtful tribute to the person who helped you. So lovely to find help offered at just the right moment.

    I've had good success with phenergan topical gel, but I have to admit that it's not as strong as the phenergan pills. If one is throwing up of course, the gel is all that's going to work. But if you can hold down pills, it might be nice to have both in your arsenal. The pills make me sleepy though. (Although when one has an upset stomach, that's no bad thing really.) As a diabetic, my doctor gives me keep small prescriptions of an assortment of "just in case" drugs that I keep on hand. I would think cancer doctors would be equally willing to let you have a little pharmakopia.

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