Why did you ask if you are smarter than me?
You know exactly what I'm talking about. Everyone has dealt with it -- some of us in 'the suck' deal with it daily. Patient presents to the POD (Pharmacist On Duty) with a random question and a product they removed from the shelf. The question is asked and regardless of how simplistic it is and how straightforward the answer may be, the patient has the gall, the arrogance, the nerve, and the self-centeredness to argue, rebut, or question your expert opinion...that THEY ASKED FOR. You didn't charge them. You didn't blow smoke up their ass. Yet, suddenly, a person that does not have a B.S. or Pharm.D. knows considerably more about pharmacy than the white-coat-wearing apothecary standing before them.
Here's my story from today (it's long, but *completely* worth it):
25-year old female and 55-year old male approach. She's holding a bottle of generic "Women's One-a-Day."
Lady: "What vitamin should I take?"
-- "Well, what are you taking them for? A doctor's suggestion?"
Lady: "No. I'm just taking them as a supplement. I don't always eat healthy."
Man: "Is this a good one?" [At this point, I look at her hand that's holding the vitamins and see that she's wearing a huge rock on her 'special' finger. She's relatively cute, and it's painfully obvious that the grisly, buck-toothed, beast of a man with her is her father.]
-- "This is just as good as the name brand stuff, and it's a lot cheaper. Are you taking and medicines? Any prescriptions, over-the-counter stuff, or herbal medications?"
Lady: "Well, I take Tegretol for simple seizures." [Bingo.]
-- "And you're not already taking a vitamin or two?" [She said, "No."] "What other prescriptions are you taking?"
Lady: "I've been taking Ortho Tri-Cyclen forever."
-- "Okay. Well, there are a couple things here. Are you aware that the Tegretol greatly reduces the effectiveness of all birth control pills? It's fine to take them as a backup, but you cannot depend on them alone to prevent pregnancy. [She nodded affirmatively as if to say, "I knew that, but I never believed it or gave a shit before."] And, due to that fact, you need to be taking Folic Acid as well."
Man: "What? Folic Acid? What about Vitamin C?"
Lady: "Yeah. I take 1,000 mg of Vitamin C a day for my immune system...to prevent colds."
Man: "How much Vitamin C is in these things?"
Lady: "It says 65 mg." [We're getting way the fuck away from where I was headed.]
Man: "Is that enough to prevent colds?" [Didn't even wanna bring up the fact that Linus Pauling faked or "misinterpreted" his data.]
-- "No. That's merely the amount you would need to prevent scurvy, and that's it. The doses I've heard used to 'bolster the immune system' range from 2 grams all the way up to 20 grams, but researchers are always going back and forth. They'll never be able to prove whether or not it actually works. You can continue to take it with this multivitamin though." [They nodded in agreement] "But, like I was saying, you need to be taking Folic Acid every day as well."
Man: "How much Folic Acid are in them?"
Lady: "It says 400 m-c-g." [At this point, the man commandeers the bottle.]
Man: "This here says that 400 is 100% of the daily value."
-- "That's exactly right. It is. But, since she is taking Tegretol and is of child bearing age, she needs to be taking a *lot* more Folic Acid.
Man: "Well how much do yoooou think she should be taking?" [He really did stretch out his word like that -- it was very accusatory, and it also activated Super-Dick Mode.]
-- "Well, she neeeeeeds to be taking, based on the number of micrograms, between 1,000 and 4,000 a day. [I'm not full of shit here. It's 1-4 mg per day if on antiepileptic, right? 4mg if you are GOING to get preggo.]
Man: "So, you're gonna stand there and tell me that she has to take 10 of these things a day?" [This statement alone proved to me that this man was, in fact, the dumbest person within a 25-mile radius of my location at that time. And I work down the street from a nursery school.]
-- "Absolutely not. She should take one of these a day just as it says. In addition to that, she should take a Folic Acid tablet or two. It's made as a supplement. We have it, and it's pretty cheap."
Man: "But this bottle says right here [He points because I can't remember what's said from one minute to the next -- apparently I resemble either a goldfish or an Alzheimer's patient in my white coat.] that one of these tablets is 100% of her daily value. Why should she take more than 100%?"
-- "The medicine she is taking for her seizures will cause birth defects should she become pregnant by accident or plan. Point blank. There's no maybe involved. It will cause birth defects. These defects are caused because of a lack of Folic Acid. By taking Folic Acid in amounts above what a normal person not taking this medicine would need, we can hope to prevent these birth defects.
Man: "I don't understand why a person would need more than 100%." [Ultra Mega Dick mode has now been activated by the degree of stupidity abound. This man treated me as a goldfish a few moments ago by pointing to a number on a bottle that I have known since I was in my first year of pharmacy school. Now, keep reading as I show him that he is the dumbest person on the face of the planet and cannot remember from one minute to the next. Now, I commandeer the bottle.]
-- "You're concerned with her taking too much Folic Acid? Let's look back. You said you were taking 1,000 mg of Vitamin C each day. Hmm. 100% of your daily dose of that is 65 mg. By my crude calculations, she's taking about 15 times her daily value. I said that 20 gram doses have been studied. That's like 30,000% of the recommended daily dose, and you didn't seem to contest doing that. The fact of that matter is that these Recommended Daily Allowances are outdated, not entirely accurate, and need updating. All I'm saying is that she needs to take one of these vitamins once a day and two or three of these Folic Acid tablets." [By this time, my wonderful tech had already retrieved a bottle of 100, written the price on a post-it, and handed it to me. So, I held up each of the bottles as I referenced them. BTW, I bought her lunch.]
-- "If you are concerned about the specifics, call her regular doctor or a gynecologist and ask them if I am lying or wrong." [I wanted to add, "...or next time, don't ask my fucking opinion if you are so qualified to make all the medical decisions."]
Man: "I don't doubt that you're right. I just don't understand why this says 100% if she needs to take more." [What? Are you fucking playing with me? I just explained that you inept asshole.]
-- "That *is* 100%. It's 100% for me -- a 30-something male because I'm not pregnant, I'm not taking medicines for seizures, I'm not sick, and I'm not a nursing mother. I have no reason for more than 100%. She does. And that is precisely why these Daily Allowances need clarification and updating.
Lady: Well, all right. Thanks a lot for the help. [I'm assuming they walked away saying, "I can't believe that guy thinks he can get pregnant. He should know that he can't get pregnant cause he don't got no boobies to feed the baby."]
-=+=-
Anyway, as headed down the aisle, I watched the man put the bottle of Folic Acid my tech had so perfectly retrieved (without prompt or request) and I handed him (which cost $2.97) on a random shelf. I wasn't even mad. Hell, I didn't give a shit then, and looking back, I care even less now. If they are that stupid/inept, it's quite likely that the child will be just as feebleminded and dimwitted as them, if he's not born a 7-lb turd with legs. With any luck, the lack of folic acid will disable her from ever reproducing.
I know that a neural tube defect will definitely keep the baby from ever being anything worthwhile (if it can be alive in the first place).
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