My Music ParadiseLet the music spice up our lives

Ah, I think my Sony Vaio is dying soon. It lags so much that it is  actually affecting  my mood now everytime I go online to surf or do my online work. I might have to look at some clearance laptops, and stock a cheap one for back up if it does crash!

Actually, Iv got a macbook as a spare, but Im just so used to using Windows, I dont think im ready to completely change OS. Darn, I feel so old, like im not adaptable to new things. Everyone is using Mac now, I should really get used to it right? But I only use my macbook when my Sony breaks down, or when I need to skype with family. Ha-ha. Silly me..

Due to the recent tsunami in Japan, I don’t think I will be going to the beach for a while now. Eventhough Malaysia isn’t affected, but I remember 2004 Tsunami in Indonesia affected some parts of Malaysia ie. Penang Island, and that has made me shun beaches since then.

This time around visiting home in 2 weeks time, I actually planned to visit the Thai islands and Sabah, I guess I won’t be having that thought anymore, I will probably go for food hunting in the nearby places instead, like malacca, penang, singapore etc.

I have several friends in Japan, most of them are not affected by the calamity, but one of them did experience the earthquake aftershock every 20 minutes. Apparently when he got home, he found his TV, computer, and other bulky stuff all fallen off the shelf. It must be really scary for the japanese.

Following the news about japanese towns being washed away, nuclear leaks, death tolls reaching 1300, thousands still out there unaccounted for, hundreds of thousands people needing shelter really scares me a lot. It feels like tsunami is happening very frequently. Everyone has been talking about the world coming to an end, and about the movie 2012 becoming a reality. Do you believe that?

So, when you are living on your own, it is important you know the basics to fixing all the little things in your flat, ie the toilet flush, the light bulbs, changing fuse when an electrical circuit trips etc. But the most important thing is you must have a ladder or at least have some sort of metal step stools.

I have always found it a problem when it comes to household problems, sad to say, I havn’t got the basic common sense or touch to fix all these little issues in my flat. So I normally ring my renting agent to get someone in to fix them for me. However, the landlord would only pay for it once, and wouldn’t want to fund them anymore, as they are little issues, but sending people over would costs a lot of money, unless I pay it myself.

Sometimes I want to try and change the light bulb myself, only to find I havn’t got a ladder, or a step stool, not even a chair to get me up to  my lights!! I think I really should get one!!

We all know that nowadays everything requires insurance. You have got home insurance that protects your home if you encounter unfortunate events ie. flood, fire, criminal convictions, damage due to renovations etc. Then there is life insurance to help protect your dependants if you die, there are also car insurance, gadgets insurance to protect your Ipad, Iphone, Laptops, and all your valuables etc.

How about Wedding insurance?? Frankly speaking, I have no idea about this until today, when I was helping a friend to get a quote for insurance for wedding in UK. It really is good to know, because then if I get married in the future, I’d know what to do instead of having to go through it all from scratch.

Apparently you can choose a wedding insurance that covers the UK weddings, overseas weddings or even Civil Partnerships. They come in a choice of set package or you can even have it taylor made to your preference. The wedding insurance can be as cheap as £15.33, but of course, if you want your wedding to be fully covered, you will have to be ready to fock out a larger sum. At the moment, because is it valentines period, many insurance companies are offering discounts, so it would be good to look out for them, as you may get some bargains.

These wedding insurance can be taylor made to cover for supplier deposits, public liability, wedding attire, rings and also for cancellation and rearrangements, depending on what the couple’s needs are.

Excessive use of mobile phones causing damage to the ears is a well known fact. My dad’s ears have been affected by the frequent use of mobile phone without using speaker or Bluetooth headset. He has always nagged me about it too, but like we always do, we ignore it. I do realise my ears been acting a bit funny, I get some ringing sound lingering in my ears after I hang up.. I guess I really have to take this seriously, start using bluetooth or speaker when I talk on the phone before any serious damage is done.

How often do you listen to what others have to tell you?? I have to admit, I seek for a listener more than I listen. This year it is going to be different. My new year resolution is to be a better listener, to listen without interupting, and to listen, process, and consider other’s suggestions and views before rushing into any actions or decisions hastly like I have always done in the past.

I got up very early today to wait for my grocery delivery from tesco, as I booked an early slot for delivery. It is either early morning or late afternoon, since I had no food left, might as well have the delivery arrive earlier. So I was very sleepy by 12pm, but I tried to go on with my online work.

Then by 5pm, I couldn’t stand I was dozing off several times when typing my work. By the time I opened my eyes, it was already 6.30pm. My throat was so dry and painful when I got up. Even after dinner and water, it is still sore now. I hope it is just one of those come and go sore throat.

Please don’t get sick. It really isn’t the right time. Tomorrow is a long day, and will be a tough day. And it is December month, Christmas and New Year is just around the corner!!! Sick sick please go away.

The need for Emergency supplies due to the mucked up managed repeat prescriptions systems(F–S) are getting on my nerves. I have to put a full stop to giving emergency supplies. Yesterday I said No to someone who wanted some test strips, she came in telling me that the regular pharmacist knows her and would normally give them to her. OMG. Don’t even try it on me anymore. Its a NO NO NO from now onwards. She glared at me?! I asked her to get the doctor to fax a prescription or go pick it up from the surgery (the driver was on holiday), then I will do it, because it is a weekday, there is no reason why she can’t get a prescription. But she said she can’t. I dislike those looks they give you, like you OWE them something.

Today another customer shouted at me, that’s it. My patience has a limit too. She wanted her migraine tablets, but apparently it has been ordered but hasn’t come back to the pharmacy yet. She came in several times but it wasn’t there for her. So the dispenser gave the surgery a ring, and confirmed that the prescription was on its way to us (arriving next day), and was expecting me to supply it first. Right, I knew it when dispensers give me that look. I said No, of course, unless there is a faxed prescription(surgery not willing to fax). That lady, Shouted at me and said ‘ ARE YOU GIVING ME THE TABLETS OR NOT?’ I wont come back to B***S anymore. Wth. I still said no. I was going to consider, but needed to ask if she is running out today, and trying to find out why she can’t get to the surgery etc, but all she said was are you giving me the tablets?! Few minutes after she left, we received a faxed Prescription for her. See, it is possible if you be abit more responsible for your own meds.

Some customers are just rude. But I don’t blame them at all, because F–S system aka the ‘magic’ system ’should’ automatically do everything for them and be sat there on the shelf waiting for them to come pick them. But when it is not, they get so mad. And the pharmacist has to bear the consequences if it is not ready for them. I think everyone should have some responsibility in their own medicines, instead of having everything done for them.

If you have read the Pharmaceutical Journal for September, you probably noticed this recent update. You must be thinking how hardworking I am, reading my PJ. Lol. The reason I am aware of this now is because, my tutor came across an FMed 296, then saw this article on PJ, and put it in front of my face and made me read it. ha-ha. Yet another CPD!

The MOD (Military of Defence) currently has a contract with LLyods pharmacy only. So if military prescriptions are presented to non-contracted community pharmacy, what we do??

The prescription is written on a specific beige colour form – FMed 296. It is treated as a private prescription. If the patient presents their prescription to Llyods pharmacy that is contracted with MOd, he doesn’t have to pay, an invoice will be sent to the MOD directly. However, if FMed 296 is presented to other community pharmacy that is not contracted with MOD, it will be treated as a private prescription as well, but patient has to pay upfront. Then they will have to claim it back from their military unit if there is prior agreement.

For NHS prescriptions (FP10 forms), they are required to pay the normal fee if not exempted, this cost can be reclaimed by the patient from the MOD.

For ‘real’ private prescriptions (normally on white forms), patient has to pay for it, and the requirements are the same as for FMed 296, invoices not accepted by MOD from non-contracted pharmacies.

Things to look out for when dealing with military prescriptions (LPC website)

1. Codeine, and other CD schedule 4, Drugs for Erectile dysfunction, these drugs has a tight control within the military dispensing unit.

2. Prescriptions with a BFPO stamp may be generated from outside the country, should be dispensed from where it came from. Check registration of doctor with GMC before dispensing. 

3.Check handwritten prescriptions at all times, because it is unusual to get handwritten prescriptions.

Today, I was working in my pre-reg store, due to the weather, it was rather slow.

So I managed to spare some time to listen to the sales rep from Chiesi, promoting the relatively new Fostair inhalers.

Well.. this pink inhaler has been available for awhile now, but I guess not many doctors are prescribing it yet. So the company is trying very hard to sell their product through pharmacies, hoping we pharmacist can influence patients and doctors of the benefits of Fostair compared to Symbicort and Seretide inhalers (the combination inhalers).

At first I was just entertaining the sales rep, after listening to her presentation, I actually gave it a thought, and had a go at reading the leaflets to see whats so great about fostair.

Well here are some information gathered :-

• It is the first and only metered-dose inhaler combining beclomethasone and formoterol
• Comparable efficacy to symbicort and seretides
• Fast onset of bronchodilation within 1-3 minutes, and is the only formoterol containing combination in MDI
• It is now licensed to be used with aerochamber plus spacer
• Fostair is cheaper then Seretide and Symbicort (the latter being most expensive)
• Only combination inhaler that has extra fine particles , delivers 31% medication to lungs compared to 10-20%  for non-extra fine MDI (similar to QVAR)
• It is a solution formulation, it delivers uniform dose from the 1st to the final actuation, so patient doesn’t have to shake before use.

The only disadvantages are it needs to be kept in the fridge before use, once removed from fridge shelf life is 5 months, which is still pretty long considering each inhaler provides approx 1 month supply if BD dosing. Also it is not like Symbicort – SMART trial, where it is licensed to be used as a reliever as well as a preventor, Fostair is not licensed to be used as a reliever, but it does open up the airways faster, due to the extra fine particles.

I rarely see it on prescriptions, as it is still fairly new. Licensed to be used with aerochamber plus spacer only recently granted. But so far, for those who has been on Fostair has given positive feedback. I guess, it would be an alternative to think about when doing MUR, if a patient doesn’t get on with symbicort or seretide, or still dont get maximal benefit, then perhaps Fostair would be an alternative before stepping up to step 4 or 5. Also it is much cheaper than symbicort, one more thing as well, with symbicort(turbohaler), patients need to breathe in harder to get the drug into the lungs. The in-check dial device is a useful tool to determine whether the type of inhalers are suitable for the patient.

I am amazed by the management team. 2 days ago my PDDM came to visit, and offered me the store based position. Then I realised I’v been put on to work in the same store for the next couple of months, practically became a store based without getting any prior notice. I emailed my PDA immediately, she apologized, saying she had the impression I was gonna be a store based pharmacist, from where? I dont know. Today the area manager came to visit. I told him that I am not pleased with the rota. He apologized and said he realised it is not right to do that. Then he said oh, you are gonna buy a car soon right? I said no, iv changed my mind. Guess what his next suggestion was? You can get a scooter. There is another staff who is doing that to go about places. How insane is that. lol. Then after I said I still prefer to remain as a relief pharmacist, he had his last try, said perhaps you want to help out for 2-3 months? I still said no. Ok he left. My dispenser then came down from her lunch, and said oh the area manager asked me to persuade you to take on the store based offer! Omg.. how persistent can they be?! Maybe if they buy me a car, and pay for my driving test, I would consider, or just give me a pay rise. If not, they can dream on.

That is not it, the words they used amazes me. They said, we dont normally offer a newly qualified store based position, we hear that you are like a dream pharmacist? you are the best one we have in the area? omg.. its only my 3rd week as qualified pharmacist, how would I be soo good. I realised they are just being nice, and trying to talk me into it. I think I dont really like management people. They always have motives! Ishh. They even said their intention was good. OKay.