Not worth the gas

2002-08-29 - 3:07 p.m.

I give up on this diaryland thing. It won't let me change anything. I can't change the color and I can't change my profile. I fill out the forms and then it says "Yay, you changed your stuff!" but when I go to check it out, nothing has changed.

Today was a very slow day. I went to North East first and they had nothing for me to do except take care of their refills. I did that and then still had two hours to spare. I spent one hour studying some stuff and then left early. I also got a couple of interesting questions from Dr. Werner. Well, mostly they were interesting due to the fact that they were something to do. The first one was about a patient who had ascites. He was currently on low dose spironolactone and low dose furosemide. She wanted to know what else she could do. I was able to adequately answer her question by telling her that usually the dose of spironolactone is maxed out before furosemide is added, but it should be ok to increase the spironolactone dose. The other question was regarding a white male in his mid-thirties with a history of seizure disorder. He has been well-controlled on his current therapy but ran out of medication 3 weeks ago and decided to take matters into his own hands by discontinuing his medication at that point. Of course that is a rather unwise course of action. Today he presented to the clinic complaining of experiencing three seizures in the last 24-hour period. So the question was at this point does he need to be reloaded with his phenytoin or is it ok to just restart his maintenance dose? And, upon telling her that a loading dose would be nice, she asked what exactly would that loading dose be? I didn't know that one off the top of my head, but had a handy-dandy reference book close at hand to provide the answer. So I was at least feeling slightly useful at that point. After leaving an hour early I decided to come home to eat lunch (also because I realized I had left my driver's license at home) and then drive out to the South City clinic. At South City absolutely nothing was going on. South City is nice because I have my own desk there and a key to the back door. But there were no patients scheduled to see the pharmacist and absolutley no reason for me to be there. So I cleaned up my work e-mail did a little more research about ascites for my own curiosity and then read a chapter from "Plains of Passage" before deciding to just go home. And now here I am. "Plains of Passage" is like flipping back and forth between a National Geographic special and a porn channel. It's like, "Ooo, look at all the beautiful plants! Let's have sex! Look at the plethora of wildlife! Let's have sex!" It's actually the most boring of Auel's books that I've read so far.

Oh, we had a somewhat interesting case come in today. Two children came in with this horrible ugly rash all over them. They had just moved to California from Iowa two days ago. The receptionist person who saw them first was convinced it was small pox or something equally hideous and contagious. She made them wait outside the building and the doctors went outside to see them. Every single doctor and NP in the clinic went out to have a gander at the rash. Finally they decided that what they actually had was a bad case of schistosomiasis (swimmer's itch), but that was after conferring several dermatology texts. We don't have schistosomes here. It's sort of an interesting thing...schistosomes are tiny tapeworms that usually live half their lives in snails, the other half in ducks. But when people get in the water they can pick up the tapeworm that is actually looking for a duck. The tapeworm burrows into the human's skin, but since the human is not a duck, the tapeworm quickly dies. Usually the first time someone is exposed to schistosomes there is no reaction. But on subsequent exposures they produce an allergic reaction. At every spot a schistosome burrowed in and died, a large puritic papule is formed. The treatment is purely symptomatic. I just looked at the CDC web page and became a little bit confused. Apparently there are two different syndromes both called schistosomiasis, although I'm not quite certain. One of them is not found in the U.S. and it kills people because the tapeworm doesn't die. Instead it burrows in and causes liver damage and other yucky stuff. The other one, which is found in the U.S., is also known as cercarial dermatitis and it is just a nuisance.

I got an e-mail from the pharmacy director at the hospital today. He wants me to come up with good ideas for things that we, the pharmacy residents and maybe the rest of the pharmacy staff too, can do for National Pharmacy Week by next Tuesday. I'm alarmingly short on ideas. I've never quite understood this. For some reason when it's National Teacher Week or National Nursing Week people throw parties for the teachers or the nurses or whoever. But during National Pharmacy Week, the pharmacists are supposed to do cool stuff for everyone else. How is this fair? Not that I need a party thrown for me, I'm just lazy. Besides, we do cool stuff for people all the time! Oh well, so far my ideas are blood pressure screening (boring!) or maybe a brown bag event. I don't really know how to do the brown bag in the hospital though. Most people who visit the hospital don't come for pleasure and are unlikely to come prepared for it. And the patients obviously don't need it. Maybe we could do a whole bunch of inservices for nurses on practical pharmacy stuff? But I sure don't want to have to set it up. Maybe we could give tours through the pharmacy to show everyone what goes on behind the scenes. With free samples...hee hee.

I just got an e-mail from someone I met on the internet. I've exchanged several e-mails with him and greatly increased the length of my books-to-read list in the process. Recently he's been making requests for me to meet him in real life. I'd been politely declining but finally decided I needed to be a little more obvious about it. (I've never really understood the way guys refuse to understand a polite no. To them a polite no means, maybe if you are more persistent you will be successful. Instead you have to make it plain that no really does mean no and further requests will also be declined so please lay off! At which point they think you're a bitch and promptly get defensive or even offensive.) So I told him "I should let you know that I'm not really interested in getting together with anyone I've met over the internet. It's sort of a general rule I follow, not anything personal." I thought that was nice enough. Not exactly true, I am not entirely opposed to meeting people I have met on the net (although I have never done it), I just didn't want to meet him. I *do* have a boyfriend after all and I *did* clearly state in the beginning that I am not looking for romance. Oh well, I guess it's really his problem not mine. He's the one in a huff, not me. I just think its too bad that I've lost those pleasant e-mails.