Rookie mistake

We are rolling towards another week of real Alaska on the water and in the mountains of Halibut cove. Always a wonderful feeling heading this way. I love Anchorage but it sure is nice to leave the city for a while. Always a little nerve wracking given my situation. I have to juggle lab timing and make sure all my meds are available. I spent this morning dealing with those issues.

I actually had some issues this morning. I have been holding off restarting my PCP prophylaxis (nasty pneumonia causing bug which I could happen into with my suppressed immune system). I was waiting because of my kidney function. I elected to start a newer drug atovaquone rather than the first choice bactrim because of the poor kidney numbers. The second choice of dapsone is out because it was making me break my own red blood cells. So now I get this lovely bright yellow overly sweet syrup. The reason I had an issue was that despite having ordered the med on Tuesday it still wasn’t ready.

I decided as we left town to stop in once more and see. The nice lady at the pharmacy said “we just got it” and pointed to a small group of boxes but said it would be at least an hour. We had already delayed our departure to give them some time. I was a little awe struck. I just stood there and stared at the boxes. The lady sort of looked at me and said “can I help”. I snapped out of it and mentioned that I was leaving, already behind, and wouldn’t be anywhere near again for over a week. I mentioned that this was a fairly important prophylaxis drug. She did nothing. I couldn’t help but ask her if she saw the irony. Here I was I could reach out and touch a medicine which may keep me healthy but she wouldn’t give it to me because she needed to log it.

Now I admit I don’t know what the “logging” process entails but given the automation and computerization of most tasks these days I could only guess it would take 10-15 min tops. She didn’t budge. Just a blank stare. I returned the empty minded glare. Maybe 30 seconds later she relented and said to come back in a few minutes. I left to find the kids and Brooke picking up some new books for the trip. I let Brooke know the situation and returned. This time the clerk got the pharmacist who informed me she needed to post the order. More blank staring. I ended up waiting another 15 minutes during which per walgreens business model I lost and ended up buying some crap I didn’t really need. Eventually with a lame grin on the face of the clerk I did exit with my medication but at least now I will have some third line protection.

The other funny issue was that I went to check my kidney function to see if recently trying to drowned myself in water was turning the numbers around and not dropping my sodium. I really like the crew at the lab. I even like it more when they give me a trainee. They are to easy to rattle. The nice girl I got today was pleasant and did a fine job removing my blood. She made a very rookie medical professional mistake. We kept talking about her rotation in the outpatient lab and how she liked patient interaction as well as the microscopy stuff. Somewhere she asked me why I was getting a lab draw and I mentioned leukemia. Then she said “I saw some cool leukemia cells the other day.” I had a little chuckle then gave her a little teaching point. No leukemia cells are cool especially not to patients. They may be interesting and exciting to a student but she had to remember even without a person in front of you as a provider there is a person and a worried crew surrounding that number, that cell, that result somewhere and her phrasing of her thoughts required more tact as she joined the medical world. I was less abrasive than I would have been to a resident or a med student. She was apologetic but did not need to be. We all learn from mistakes. At least we should try. I still left a little sad that someone had leukemia cells though.

Head Up, Heart Strong. I need a cure

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