I recommend talking to different care givers and sources of information when faced with an illness. Specialists, nurses, pharmacists, herbalists, chiropractors and the person next door who has a relative who had something similar-- any one might have a piece of information that helps make healing possible.  Accessing care and information about the latest and even common folk treatments can be a labyrinth.

Just got a personal reminder of the importance of talking to people who have been through a condition to get help.

I was referred by my dentist to an oral surgeon who told me I may have a chronic infection or cancer. It might be slow growing as CT revealed it has eaten through my skull.  It might be fast as a little finger sized lump appeared between Thanksgiving and Christmas.  It might be something benign but the biopsy will be back from the lab next week.
As it is so close to the brain I have an urgency to begin treatment and I have in the past recommended Rick Simpson Oil.  I have told people how easy it is to talk to knowledgeable doctors and cannabis club owners and it how it will all go smoothly.

My experience has been frustrating: The cannabis shops cannot talk over the phone about products or benefits. They say come down to the shop.  My local shop wont let me in to ask a question without a medical authorization.  There are well dressed kids driving expensive cars in the parking lot and the place looks like a spa with color changing led lit waterfalls.  I do not want to pay an online doctor to authorize to find out the local cannabis shop does not have what I want: organic alcohol extracted oil in the tradition of Rick Simpson.

I contacted a friend with cancer and he checks for me: no.
He spends an hour explaining all the ways to use it not described in medical literature.
I call an online cannabis doctor who is more rushed than a regular MD-- no practical discussion.
I am left with the experience that the medical marijuana industry is not set up for medicine.
The rules are as Byzantine as pharmacy and the FDA prevents any actual discussion with "Bud-tenders."

Not as straight forward as I was led to believe.

I had imagined being a cancer counselor not long ago to help people navigate integrative options.
Many complementary treatments I already have in my life...interestingly I stopped my usual diet for the Holidays and stopped using numerous supplements (Curcumin and some expensive adaptogens and green drinks) and behold I was gifted a tumor.  Getting back on all of those supplements plus fermented mushrooms and hopefully with medical grade cannabis.

I really value the folks at constance therapeutics.  They are the pharmacists of medical marijuana. And I am blessed to have a friend who has personal knowledge with cancer and cannabis.


 http://constancetherapeutics.com/

Modern Alchemical Pharmacies on the Horizon

I recently spoke with a lecturer at a prominent California Pharmacy school.
He remains enthusiastic about the role and reimbursement possibilities for pharmacists to their training and expertise in drug therapy management.
Physicians send patients to physical therapists for physical therapy so it is logical to send diagnosed but difficult to treat cases to medication management therapists-- pharmacists.
I am not convinced having spent thousands of dollars over the years to be the first pharmacist on the block to provide emergency contraception, administer vaccines and offer health screening.  My experience is that all the training and collaborative agreements are first met with considerable resistance and then eventually became mandatory non reimbursed services-- more work with less time to do it.
Our conversation got interesting when discussing the current research in Schedule I and illicit drugs to treat the epidemic of PTSD and depression-- whether in veterans returning from war or citizens surviving a fast paced materialist culture.  The use of Ayahausca and Ibogaine for depression and addiction are also following the trajectory of medical marijuana as a viable but illegal form of treatment.
If the Federal government reclassifies Marijuana from Schedule I to Schedule II then under current law State Boards of Pharmacy would regulate it as medication is to be sold in licensed pharmacies by registered pharmacists.  It will be an interesting transition as there is so much art and expertise in edibles and vaporizing.  It is specialty practice.
How then might MDMA, Ibogaine, Ketamine, Ayahuasca following similar recognition of effectiveness be dispensed.  The importance of education to use medication safely takes a huge leap especially with respect to the importance of setting and intention with use.  Might the modern medicine man resume the skills of the traditional alchemist and herbalist?

The price of methadone tripled: this weekend.

From Friday to Monday the wholesale cost per bottle tripled.

The last reasonably priced pain medicine is getting sucked into the hidden-hyper-inflationary vortex of the post "affordable health care act" "health care system." 

This whole cholesterol guideline shift has been a long time coming.  An admission that the numbers don't add up is really that.  Linus Pauling and colleagues suggested decades ago that LDL was a substitute for low antioxidants and that was the actual MOA of Statins benefit.
So many examples of where the pharmaceutical industry FDA marriage has got it wrong: Atenolol turned out to be BID after decades of QD dosing.  More...

As a pharmacist I attempt to answer the phone with a succinct and friendly greeting.

"Thanks for calling, how can I help you?"

Yesterday morning my perky greeting was shouted down with a rapid fire staccato name of a person and medication.

I paused..."I am sorry...that was not a complete sentence...I don't understand...how can I help you?"

Loud crash of phone into its cradle.

I am still amazed after 20 years how rude people can be to those who attempt serve them.

Ordering Vaccines

A pediatrician asked a pharmacist to order some vaccines....
Sounds like the start of a good joke.  But it is not.

The drug wholesaler's (and there are three) websites and search engines for finding products are almost useful.

Example:

Nearly all healthcare workers refer to the Measles Mumps Rubella vaccine as "MMR."
Yet a search for that drug in a prominent wholesaler order database comes up empty.  EM-TEE.

To order an MMR one has to enter "M-M-R II" as there is no boolean option, no list of common vaccines, no amazon style "other health care providers who shopped for vaccines bought..."

You just have to know.  Or spend a half hour on the phone to find out.  And then you know.

"W-T-F-!!"

Covert Flash Hyperinflation

The price of oxycodone 15mg went up by a factor of four TODAY.
The reimbursement to the pharmacy by insurance companies has not.

So Mr. Smith who dropped off his pain prescription yesterday is in the pharmacy waiting-- in pain.
And we are looking at a seventy something dollar loss to provide one of his maintenance pain meds.

This flash hyper inflation is becoming de rigueur since the affordable care act took effect.  At a 400% increase in cost overnight and NO increase in reimbursement pharmacies are forced to take the hit to keep the patient or send them on their way to a Wall Street funded too big to fail pharmacy.

In a few weeks the insurance companies will increase reimbursement approaching the cost.  But daily I am seeing more and more losses where the reimbursement is below acquisition cost.  This pattern seems to be cycling through all the CIIs and other medications as well.

In this day and age of high frequency trading I have to wonder if it is part of a CVS Caremark /Express Scripts-MerckMedco/Prime-BlueCross/OptumRx-United Health/Catamaran  vertical integration hostile takeover and domination of all of "Healthcare (tm)" by insurance companies.