Sharing LARGE fruits

In the Stone Age, I imagine that I might have to change "fruits" in my title to "animals."

By now, I've been living on my own for about 2 years. I just stopped by the nearby WholeFoods to pick up some soy products, soy milk, and tofu. While exiting the front door, I saw the usual large crates of large fruits, organic cantaloupes and seedless watermelons, near the entrance.

Suddenly, for whatever reasons, they're not even my favorite fruits, I started missing living with my family, where large fruits can be purchased any time because there were 4 sets of GI systems :)

Perfume

Everyone knows the function of perfume. I just realize that often meats taste nicer with sweet and aromatic compliments such as honey and cranberry. Can we say honey and cranberry are "perfume" to cover up the scent of meats?

Coin Operated

As an apartment inhabitant, I frequented the basement for its washing/drying machines. When I deposited coins into the washing machine, I made sure I counted the right numbers of coins. It, like a typical machine, was programmed to start only when sufficient coins were deposited. One time, despite my years of education, I gave it one more coin accidentally. It did NOT refund me my money :(

I like to think that being a student, our required duty is like the load of clothes. We study in order to meet the required duty. Similar to the machines in my basement, our required duty would ONLY require the exact effort. I'm not sure if we were to put forth extra effort, those extra effort can be rewarded with interest to be used later...

My exercise: talking

Some professors are too busy to exercise even though EVERYONE knows that exercise is mandatory to stay healthy. I notice this SMART pediatric professor using presenting lectures as an exercise.

NO, she did not run up and down stairs. NO, she did not do squats in that tiny podium. NO, she did not do sit-ups on the large table at the front of the room. She did however present ONE WHOLE PowerPoint SLIDE with just ONE breath...

In the Water World, she would have no trouble finding a job!!

ps. we were impressed with her lung capacity; material-wise, we were less impressed.

"No, I don't drink"

vs.

As a healthcare professional student, I now hear more of "No, I don't drink!" To elaborate, "No, I don't drink sugary soft drink. More wine, please!"

Leaves almost kill...

The gravity pulled fallen leaves downward towards earth. Gusty wind came out of nowhere, and forced me to blink. One leaf changed its direction, and flew towards my eyes. Luckily, my blinking saved my eye.

I looked at the leaf, now lifeless on the pavement. It might have changed my life...thanks to the wind.

Thought of you

Smooth Ride

It was Friday evening on campus.

As you can see, the scene is virtually moon-like, inanimate and sparse.

Just a minute ago, I was all the way on the 9th floor.

Normally, it would take several minutes for the elevators, stopping by every floor along the way, to reach most people's destinations (janitorial staff might need to go further down), 1st floor.

Today was different. It went STRAIGHT down without changing gear, like a hot knife through soft butter. I didn't even have time to roll up my sleeve to check out the time on my watch!

This was Friday evening on campus.

Anonymous female swimmer

Just came back from the swimming pool at the school gym. When I arrived at the pool, I picked an empty lane. A minute later, a female swimmer came into my lane, and we shared the lane together. She could have picked other lanes to share with other swimmers, but she picked mine.

I was happy because she seemed pretty. My aged swimming goggle has LOW resolution. So we began at about the same time. Pretty soon, I realized she's in far better condition than I was. In other words, she was like a dolphin while I was still a terrestrial human. I finally struggled to finish my 20-minute swim (a near life-and-death struggle) while she seemed to have just warmed up and continued adding up laps after laps.

I concluded that she picked my lane, and NOT other lanes which were all occupied by WOMEN because she figured I might be a worthy competitor (being a guy, who naturally produces more testosterone), and that I could possibly push her towards a new height.

Hahahaha...

(she is pretty, right?)

CSHP Industry Night...?

Just came back from a CSHP Golden Gate chapter event, "6th Annual Night Out With Industry." Let me de-mystify this introductory sentence term by term.

CSHP = California Society of Health-System Pharmacists is a pharmacy organization in California, and people (pharmacists, student pharmacists and pharmacy technicians) who work in hospital pharmacies constitute its membership. Supposedly, it is the largest pharmacy organization in California. How many members? Haha...great question! Who am I? Am I a Google engineer? Do I know the answer like that? NO, no clue.

Industry = Pharmaceutical Industry, or Big Pharma.

In summary, it is a night where drug representatives from various companies educate us students and pharmacists about their products. I used "educate" since it paints a more favorable picture, but I suppose you can also use "sell."

My conclusion is if you talk to just one company, you will be easily convinced that they make the BEST medication!! Comparison shop is the key, like dating.

Here are some pictures I took of the variety of medication pamphlets and souvenirs. My guess is you know none of the drugs, but they do have nicely designed packaging! Enjoy, and think about their motivation!

As titled, "6th Annual Night Out With Industry"

Victoza? It's a diabetes medication.

Humira? And how do you pronounce "adalimumab"? Why are there 2 names? The nice-sounding one is usually the BRAND name, and by design can be recalled by people, patients as well as us health care professionals easily. "Adalimumab" below is the weird-sounding GENERIC name. It's a more systematic name so can be more easily classified. We are humans, or Home Sapiens. Same idea here. So Humira is an injection that treats autoimmune diseases, some examples are Crohn's disease, and rheumatoid arthritis.

Nice cow, specifically an Apis bull, a sacred animal in ancient Egypt. It's an insulin company. Yes, insulin is a drug even though we also make them ourselves. Hmm, interesting! Where do they get the insulin from? From us? Great question! No, originally insulin was first taken from pigs (porcine) and cows (bovine). Currently, all insulin are made from DNA technology, and they look like our own insulin.

Look at how many companies are present! We were having some raffle drawing, and we needed to collect sitckers from different venders. Pfizer is covered by Sponge Bob.

Nice souvenir notebook! It also has all the information about the drug, Emend, which helps nausea side effects of many chemotherapeutic drugs. It also includes a nice bookmark, "I am seeking, I am striving, I am in it with all my heart -- by Vincent van Gogh."

Toviaz, hmm, sounds European. Fesoterodine fumarate, on the other hand, just sounds non-sense. Toviaz treats Over-Active Bladder (OAB), or urinary incontinence. Doesn't OAB look like some sort of blood type? And look at the freely jumping human figure next to the drug name. Association at work here: happy human figure BECAUSE of Toviaz!

Lancet, the world's leading general medical journal and specialty journals in Oncology, Neurology, and Infectious Diseases according to thelancet.com. I suppose having your drug study published here is a big deal. For example, I have ZERO article published anywhere. Fampridine is another weird-sounding drug for a serious disease, multiple sclerosis.

New England Journal of Medicine should need no more introduction, right? The drug is Xifaxan. Cool sounding drug with a neat neon-green light bulb. It treats a serious neurological complication of liver cirrhosis. On the post-it note, in addition to the neon-green light bulb, and a large Rx font, it kindly reminds doctors to make sure give the patients 11 refills, and with the original script, constitute one-year worth of Xifaxan.

Relistor, methyl-nal-trex-one ("I can read it, I can read it!!!" You're welcome.), relieves constipation caused by taking opioid drugs (Vicodin is an example.) I am guessing Relistor sounds like relief? Ok, very creative!!

Big Pharma is all about creativity, not only in the Research & Development stage, but also in marketing stage.

Water-resistant watch

It allows me fix the old plug without having to take off my watch. Great!

However, I can always just take off my watch.

ps. A watch I inherited from dad.

Drug Addiction - confessions

Just came back from a DRUG ABUSE lecture. Here are some very interesting excerpts from the confessions of addicts. These are all health care professionals, in their middle age.

“…I find it funny when people talk about the signs of addiction as being poor attendance at work and not showing up. That’s alcoholism, just the opposite of what happened to me.

With “Fentanylism” it’s showing up and working 24 hour days and relieving somebody of their cases, especially if it was a heart patient and a lot of fentanyl was used. I would offer to relieve you, let you get a cup of coffee. Then I would sample from the large amount of Fentanyl we had in the case" (MD, age 48)

“…I used to read the PDR like it was a novel. I looked for new controlled drugs, and when I found one that sounded great, I would mail order a 1000 of them. I could order a 1000 barbiturates for 20-30 dollars. If I liked them, I’d order 5000. Access was no problem for me" (MD, age 38)

“…At the worst period of my addiction, I was taking 150 Percodan tablets just to get through the day- 25 at a time without water. After a while there was no high involved. I used them just to get rid of the withdrawal symptoms. I had built up my tolerance to these narcotics that I could take 25 at a time and still function. It ate a big hole in my stomach. When I went to rehab I had a huge ulcer that they treated as life-threatening. But I didn’t care about killing myself. I needed those drugs. I had pain." (PharmD, age 41)

“…When an order came in for Demerol, I would steal the Demerol and put water back into the bottle. The obsession was terrible. I would come in every morning pledging that I’m not going to do it. But I did I’d feel guilty as hell thinking about the patient getting watered-down Demerol. Im a good pharmacist, a good person, Despite my shame and guilt, the same thing

happened all over again." (PharmD, age 46)

“… The thought of living without drugs was enough to drive me crazy. My mental condition focused constantly on getting through the day. OK, I know I need 150 Percodans to get

through the day but I only have 140. I would plan how to steal them. And God help me if I had to go out of town. I would need 1,000 pills for a five-day trip. I had to find them

and take them with me. I had stashes all over the house, the car, the garage. There are still hundreds of pills out there. God only knows where they are." (PharmD, age 41)

“…I shot up a lot with Demerol. Once I passed out and fell into the cabinet; another time I shot up and fell into the toilet. I had lost everything-my license, my wife, my family. I had nothing left and nowhere to turn. It was either get straight or die." (MD, age 50)

“…I remember taking massive doses of valium and cardiac pills the second time I tried to commit suicide. They should have killed me… I woke up with my AA sponsor slapping me in the face. For some reason I saved all the empty bottles-that saved my ass. I had 32 different

drugs in my system and for 24 hours they didn’t know if I would make it or not.” (PharmD, age 49)

“….During a stressful day in dental school a classmate gave me a few 10 mg Valium tablets. The feeling that came over me was far better than any I ever had while drinking. I had never felt so good. I also discovered that drinking a few beers later that day potentiated the wonderful feelings I had experienced earlier. I justified my drug usage by rationalizing that if I worked hard I would treat myself. I would ‘treat’ myself to a Demerol cocktail at the end of the day. Then after a few weeks, I would not only treat myself to one after work, but one just before bed time. By this time I had begun taking both Valium and Demerol during the day just to maintain a certain feeling of being ‘normal” (DDS, age 42)

"The Spirit Catches You and You Fall Down" - "The Big One"

Here is the chapter that is just awesome, even to a pharmacy student! Again, Lia Lee, the little Hmong girl, suffers a refractory epilepsy.

From "The Spirit Catches You and You Fall Down," by Anne Fadiman,

Chapter 11. The Big One

On November 25, 1986, the day before Thanksgiving, the Lees were eating dinner. Lia, who had had a mild runny nose for several days, sat in her usual chair at the round white Formica table in the kitchen, surrounded by her parents, five of her sisters, and her brother. She was normally an avid eater, but tonight she had little appetite, and fed herself only a little rice and water. After she finished eating, her face took on the strange, frightened expression that always preceded an apileptic seizure. She ran to her parents, hugged them, and fell down, her arms and legs first stiffening and then jerking furiously. Nao Kao picked her up and laid her on the blue quilted pad they always kept ready for her on the living room floor.

"When the spirit caught Lia and she fell down," said Nao Kao, "she was usually sick for ten minutes or so. After that, she would be normal again, and if you gave her rice, she ate it. But this time she was really sick for a long time, so we had to call our nephew because he spoke English and he knew how to call an ambulance." On every other occasion when Lia had seized, Nao Kao and Foua had carried Lia to the hospital. I asked Nao Kao why he had decided to summon an ambulance. "If you take her in an ambulance, they would pay more attention to her at the hospital," he said. "If you don't call the ambulance, those tsov tom people wouldn't look at her." May Ying hesitated before translating tsov tom, which means "tiger bite." Tigers are a symbol of wickedness and duplicity - in Hmong folktales, they steal men's wives and eat their own children - and tsov tom is a very serious curse.

It is true that, whether one is Hmong or American, arriving at an emergency room via ambulance generally does stave off the customary two-hour wait. But any patient as catastrophically ill as Lia was that night would have been instantly triaged to the front of the line, no matter how she had gone there. In fact, if her parents had run the three blocks to MCMC with Lia in their arms, they would have saved nearly twenty minutes that, in retrospect, may have been critical. As it was, it took about five minutes fro their nephew to come to their house and dial 911; one minute for the ambulance to respond to the dispatcher's call; two minutes for the ambulance to reach the Lee residence; fourteen minutes (an unusually, and in this case perhaps disastrously, long time) for the ambulance to leave the scene; and one minute to drive to the hospital.

Ok, I will continue tomorrow. My therapeutics midterm is coming up next week! You know, it's the title of the chapter. "The Big One."

"The Spirit Catches You and You Fall Down" - haunting descriptioon

I'm only half way on the book. It contains many subjects, history, health care system, cultural differences in healing, and epilepsy. From Hmong's perspective, an ethnic group from SouthEast Asia, having an epilepsy seizure is like "the spirit catches you, and you fall down." Lia, the little girl, who was otherwise robust and lively, had been fighting epilepsy, but medications had not been able to control her increasingly frequent seizures. Her pediatrician feared a deadly seizure episode was inevitable. Here it is on pg. 140, "The Big One"

I will continue to post tomorrow. Though the description was haunting, I am just too sleepy.

Blogging before therapeutics lecture!

Time of blogging? Does it matter? Why is it worth noting that this blog entry comes the night before a therapeutics lecture? As a student pharmacist, therapeutics series is the MOST IMPORTANT life-and-death type of classes for us. If we do well, life will be rosy. Otherwise, you can come up with your own antonym for rosy. I have one for you, "bleak."

Sacrificing time to study and re-study just to post a blog about a topic that NO ONE (even my mom; though to be fair, her native language isn't English) is interested in? WHY???

My philosophy about having this blog is that I want to share with I learn as a student pharmacist. In addition, you will see that what I learn in school can be sometimes useful in your life. You never know!

Yea!!! Now I get to study my therapeutics - this quarter we're studying cardiovascular stuff...you know, hypertension, dyslipidemia (disruption in the amount of lipids in our blood), and diabetes.