A day in the life of a radical pharmacy owner

I was going to write about my love of roller coaster. It is a beautiful day which makes me think of the opening of Carowinds. I feel like such a light topic is inappropriate today as the senate just confirmed Alito. I knew this day was coming, but I still feel sort of sick to my stomach. This is not a political blog. However, I am a political person so I felt that I should say something about this.

I am not sure how the two new justices will affect my every day existence.

I am really at a loss and it sucks :(

I think I will numb my pain by playing the State of the Union Address Drinking Game. You can find the official rules at http://www.drinkinggame./ J and I will be playing a modified version (I will be drinking beer and J will be drinking Spirit). We are going to choose 2 words or phrases and drink when those words are said. I will be drinking when he says "health care" and "terrorist". J will be drinking to "nuclear" and "safety". Happy State of the Union!

So, Target finally fired Heather Williams, an anti-choice activist pharmacist, for refusing to fill a prescription for Plan B. You can read the story here:

http://www.stltoday.com/stltoday/news/stories.nsf/stlouiscitycounty/story/F66D4B9D4D4E342E8625710300039083?OpenDocument

Not only did she refuse to fill it, but she also would not provide information on where else the patient fill the prescription. Target requires its pharmacist to help the patient if they do not want to fill it. I think I should mail her a copy of my article. I just don't understand why she hasn't gotten a job where she doesn't have to fill those types of prescriptions. She could work for a private, religious hospital. She could work in a nuclear pharmacy (they fill cancer medications). She could work at a mail order pharmacy. She could work for WalMart. She could open her own pharmacy and have whatever policy she wants. I think she has been waiting for the last 5 years to victimize and humiliate a patient. People like her should be punished by their state boards of pharmacy. I think she should be fined and put on probation. If she does it again, she should lose her license. I was on another blog yesterday that covered this story. Another reader commented that they believed that this attitude that one can preach from behind the counter begins in pharmacy school. I wrote in and agreed. The moderator of the blog contacted me to ask if I would be interested in participating in a story. I will link the story when it is written.

In other news, the building across the street was flooding this morning. Apparently, a pipe near the water heater burst. The building is unoccupied so I had to make several calls and a short trip to the sheriff's substation up the street. They got the water turned off 2 hours after we noticed.

I talked to my banker today. She says that she just needs a document to secure the collateral. After that, we can wrap things up in 24 hours. Next Tuesday, my wholesaler is coming for all of the money I owe them. The timing of the loan is perfect. They actually tried to take out a payment this week after agreeing to hold off until January 31st. The credit manager is obviously not on the same page with the rest of the friendly, flexible people he works with. I have been in a state of panic about money since July. I hope this takes it down a notch. I will still be dirt poor, but at least my wholesaler won't be breathing down my neck.

Business continues to grow. We have already seen 4% growth this month and we still have 4 more business days. I had projected a growth rate of 15% per month. Last month, we had 39% growth in sales. We have had several positive comments posted on the Pleasantville message board.

I attended the Merchant Guild meeting. The merchants of the various stores sit down with staff of the property management group. We talk about marketing opportunities and issues that concern us. Today, a major concern was the kids and their skateboards on our sidewalks. Oh, my god, I am so old. I can't believe I was at a meeting where the topic of discussion was the banning of skateboards and scooters. I suggested if we were going to ban them that we create a space where the kids could skate. That was immediately shot down because the property group would have to be liable for such a space. I felt like I was at a meeting with "The Man". I tried to speak up for the poor oppressed skaters. One member requested that we have signs made that say "No skateboards. No scooters." Another member, a deli owner, pointed out that the skaters and the other kids support his business. It was tabled for now. If they can put up skate signs, I wonder if I can put up a sign that says:

"Please do not park in front of the pharmacy if you are not using the pharmacy. There is 150 car parking lot right across the street for you to use when eating at the deli. Thank you!"

We need some new businesses to open up, but we spent 20 minutes discussing skaters. Eeek.

"Your total is $40.47"
"My co-pay is always $15.00"
"Yes, madam, I believe you have to meet a deductible at the beginning of each year before your co-pay kicks in."
"But, I have never had a deductible before." She looks at me with suspicion.
"My partner is also on this insurance plan. They changed things at the beginning of this year."
"We did not have to meet a deductible last year."
"I can call your insurance company and ask them why you have to pay $40 instead of $15."
"Please do that" she says in an accusatory tone.

I call her insurance company. They tell me what I told her. They have changed the plan and each member of the family must now meet a $50 deductible before getting the flat co-pay. I get off the phone and relay the information.

"Well, we did get a bunch of papers from the insurance company and I never read them."

I struggle not to roll my eyes.

"Every family member has a $50 deductible? We went to CVS for some medication for my son this weekend and it was only $6.00."
"Well, there are two possible reasons for that. Children may be except from the deductible. By the way, what was the medication?"
"We got a few suppositories for his upset stomach."
"The second possibility is that you had to pay for the medication and that will be applied to his deductible. That is not expensive medication"
"Okay." she said with doubt in her expression.

Why are you here in my store if you think I am trying to cheat you? I really want your business, but you need to understand how this pharmacy insurance thing works. I am very familiar with this plan and well as several others as it is part of my job.

Prescription insurance works like this. You or you employer pays a premium divided up monthly. The premium is your contribution to the plan's payment fund. I pay $155.00 a month or about $1,900 a year for my premium for my whole health insurance policy. Most plans also have a deductible or a part that you must pay before the insurance helps pay. K and I have an individual health policy. Our deductible for prescriptions is $5,000 each. Our deductible for medical care is also $5,000 each. After we pay $5,000 of our prescriptions or medical care, everything is cover 100%. Our premium is pretty reasonable, but the trade off is the very high deductible. This is the only way I can keep us covered right now. The premiums, deductibles, and products and services covered are usually up for review each year. Deductibles have been very common for physicians visits and hospitalizations. Now, they are becoming very common in pharmacy benefits as insurance companies' profits are decreasing with the rising cost of health care.

I don't make up these policies. In fact, I don't even make up the price you paid for the medication. If you were a cash paying customer, I would have asked $51.65 for the medication. Your insurance company said that I can only charge you $40.47 which just covers the medication, the label, and my overhead. Notice, I didn't mention my professional services including the time I took to call your insurance company. I knew all of this before I opened my store. I didn't go into this business to become a millionaire (Sorry, J). I love my job, but I hate it when you assume that I am trying to screw you. I especially hate it when you don't read up on your own insurance information. I hate when you don't believe me that you will pay the same at CVS.

Part of me wants to tell you to go back to CVS and maybe you will after our little exchange. I don't mind answering question about the price of your medication, but please treat me with the respect that a professional in my position deserves. Yes, I know your husband is a doctor. I am also a doctor as is my partner. With that said, let's start over.

"Your total is $40.47"
"I sure will be glad when I meet my $50.00 deductible. This should put me pretty close to right?"
"Yes, madam. I hope you feel better after taking your medication."
"Thanks. I am sure I will. I just glad that I am one of the fortunate people in this country that has health insurance. See you later."

See. I still got the same amount for your prescription and a warm fuzzy from your grateful attitude.

I had a request from a fellow blogger to tell about transitioned from married person to my current relationship. I have been reading his blog, http://incongruent-affect.blogspot.com/. It is made up of several bloggers who are friends/family. It is entertaining (although, I must admit skipping the extensive posts on sports) and has posts on a variety of topics from TV to political events. Check out the June 2005 archives for several posts about the craziness of Tom Cruise and Scientologist. I went to www.xenu.net. It is an anti-Scientology website with some very compelling information.

I married X nine years ago when I was pregnant with K. It was karma kicking my ass for saying at age 19:

"Only a dumb ass gets married while they are pregnant. She looks miserable"

So, three years later I was the one looking fat and miserable while my whole family and all my friends were getting drunk at my wedding. I believed I was doing the right thing and that I was making a vow "until death do us part". However, I also locked my keys in my car three times (once while it was running), changed my last name, and took a job a Piccadilly restaurant while I was pregnant. I maintain to this day that pregnancy impairs one's judgment and all major life decisions should be made 1 year after the baby is born.

When, I met X he knew that I was bisexual. In fact, we met because this girl wanted to sleep with both of us. He encouraged me to pursue relationships with woman. We talked about polyamory. He felt that I could have a romantic/sexual relationship with a woman, but not another man. We had several discussions about this over the years. I never really explored any other relationships because we never agreed on the rules on how to handle other relationships.

I met J during my second-to-last clinical rotation in pharmacy school. She was doing inpatient psychiatry at the VA. I was doing my psychiatric pharmacy rotation. During the second day of rotation, she mentioned her ex-girlfriend, her work on the Howard Dean campaign, and the UU church in Washington D.C. I knew that I wanted to get to know her since it is not often that I meet someone with so much in common with me. We began hanging out, getting to know each other, watching the L word, and eating out together. I remember feeling like I was out on a date particularly the first time we went out to eat together. We went to a Lebanese restaurant that I love. J tried many new things at that restaurant (to impress me) that she will never eat again.

Meanwhile, X and I had been struggling over how we were going to deal with 2 new careers. He lived in D.C. and wanted me to move there. He even started hunting for houses. I was uneasy about moving far from my friends and family, starting a new career, and trying to save a failing marriage. I decided that a move would be too much of a strain on me and K.

I planned a trip to Washington D.C. at the end of my final rotation to participated in the March to Save Women's Lives. J invited herself to go with me. She will tell you that she did not invite herself, but this is my blog and I will tell the story as I remember it. We drove through Durham to pick up friends. We forced our friends to ride from Durham to D.C. together so they could get to know each better. Actually, I think it was part of J's plan to seduce me. We stayed with X and his roommates. He asked me about my relationship with J. I told him she wasn't interested in me (I can be totally clueless at times).

It was the ride home when J turned up the charm. We had picked up K in Washington. He had been traveling with his grandparents for spring break. He had diarrhea and we had a long drive home. She taught him how to swallow a pill by telling him it was like a minnow swimming down his throat. We left late in the afternoon from D.C. and it is an eight hour drive from here. She got sleepy, as she usually does on trips. Then, I got sleepy. She started to rub the back of my neck and my hair to help me stay awake. It helped me wake up and made me want to kiss her desperately. The rest of the details are between J and I. :)

I was seduced, willingly and totally. I fell in love her that night/morning. I naively thought that I could maintain a relationship with J and X. It did not work. I wish that I had ended my relationship with X before beginning one with J. It would have spared all of us some of the pain.
I don't regret for one second leaving X. Our marriage was over. We were both fighting to control each others lives and futures. All we were successfully doing was beating the shit out of each other. J and I fight at times, but it is not a power struggle. Since she is a psychiatrist, we always resolve the argument before bedtime.

I love her more than I thought possible. We are two peas in a pod.

I wrote the following article last spring. It was published in the South Carolina Pharmacy Association's monthly publication. It went out to over 2,000 pharmacist, technicians, and pharmacy students that are members of the association.

During my first year of pharmacy school, I had a class that covered several topics that were relevant to the practice of pharmacy, but did not warrant enough attention for a full course. One of the areas we covered in the class was medical ethics. We examined several hypothetical situations in which our personal beliefs may have been challenged by a medical decision we were asked to make. Pharmacists as recently as last month have been making headlines across the country by refusing to dispense birth control pills and/or emergency contraception. Do pharmacists have the right to refuse to dispense a prescription based on personal beliefs? The issue is complex.
As a body, the American Pharmacists Association has developed a code of ethics for pharmacists. The code includes the following eight principals:

I. A pharmacist respects the covenantal relationship between the patient and pharmacist.

II. A pharmacist promotes the good of every patient in a caring, compassionate, and confidential manner.

III. A pharmacist respects the autonomy and dignity of each patient.

IV. A pharmacist acts with honesty and integrity in professional relationships.

V. A pharmacist maintains professional competence.

VI. A pharmacist respects the values and abilities of colleagues and other health professionals.

VII. A pharmacist serves individual, community, and societal needs.

VIII. A pharmacist seeks justice in the distribution of health resources.

By applying this code of ethics, the argument can be made for either side of the issue. A pharmacist may believe they are placing the well-being of the patient ahead of the patient's desires by refusing to dispense a lethal dose of a medication prescribe to assist in the patient's suicide. On the other hand, one could argue that by refusing to dispense birth-control pills the pharmacist is not respecting the autonomy and dignity of the patient. I believe the take home message from the class that I attended was to put confidentiality and professional judgment above personal beliefs. However, I think the instructor also promoted the individual pharmacist's right to dispense or to refuse to dispense. How can a young pharmacist fulfill their obligations to the patients and to their conscience? I believe that the answer lies in planning. It is important to understand before practicing what issues may cause a moral dilemma to the individual pharmacist. This approach can minimize the impact of the decision for the patient. If you are strongly against the use of emergency contraception, you can avoid impacting a patient’s right by working in a pharmacy that does not stock birth control products or by working with another pharmacist who is willing to dispense the medications. We all have a right to our own beliefs and ethics. We do not have the right to punish patients because they do not share the same view. An open line of communication with your employer and fellow pharmacist will allow you to follow your conscience and to serve your patients with respect and dignity.


A year later, I wonder how relevant this advice will even be. I am sure that if Alito is confirmed that the Supreme Court will overturn Roe v. Wade. Abortion will be turned over to state legislators. I believe that South Carolina will lead the way in criminalizing abortion and banning the use of morning-after contraception. I try and imagine my role in community where there are no safe choices for women who do not wish to remain pregnant.

I believe strongly in a woman's right to choose. I made the trip to Washington D.C. with J and K to march in the March for Women's Lives in 2004 so I know that there are at least a million other people that feel like I do. We have to make our voices heard loudly during this critical time. We must continue contacting our legislators on national, state, and local levels to remind them that we are pro-choice and we are the majority.

I had to set the word verification for comments because I found a "comment" that links to an internet pharmacy. For those who have thought about ordering controlled substances online, don't. Many of those sites are being investigated by the DEA. They were prosecute you as well as the site owners. Telling the DEA that you did not know that it is illegal to order controlled substances online does not work. Additionally, these pharmacies are not regulated by state boards of pharmacy or anyone else. You may not even received the correct medication after you pay four times as much as you would if you filled it at my pharmacy.

I went to work at L's pharmacy because the dress code was casual, the store closed by 6:00 pm, and it was not open on Sundays. I got so much more out of the job. I was able to work under an amazing compounding technician. SB is from Germany. She was struggling through pharmacy school when she met an American military man and married him. She moved to the US with him and had 2 children. She began working part-time for a pharmacy as a compounding technician. She split with her husband shortly after her youngest born. She began working full time for L's as their compounding technician. Compounding, for those who do not know, is the creation and dispensing of FDA approved drug products in dosage delivery forms not available from manufacturers. It requires the the compounded to be comfortable doing research, to understand chemical principle, and to be able to mix and prepare things. SB drew on her schooling (which according to her was much more thorough than my schooling) and experience to transform L's compounding business into a major source of revenue. I was hired to assist her in the growing business. She convince the pharmacist to hire me because of my background in chemistry. I was drawn to it like I was drawn to chemistry and to cooking. I love the process of combining things to create something new.

SB had a reputation with the other employees as being difficult and moody at times. She did not like men very much due to her ex-husband (Knucklehead). Early on, I earned her respect through my knowledge and my attitude. I had been working there for a short time and she had asked me to do a task for her. When I fumbled with the task, she made a comment about how she had yet to meet a pharmacy student with any common sense. I told her that I had common sense, but I was unable to read minds. She was shocked that I responded, but quickly laughed. We became allies after that day. She made me laugh regularly. She encouraged me to stay with the job even when I felt like the pharmacist hated me. She taught me more about pharmacy and chemistry than either degree program I attended. She also inspired my love of independent pharmacy. I plan to expand into compounding after establishing my core business. Maybe she will want a change a scenery by then, but it is often difficult to transition from teacher to employee.

I am feeling inspired today. I had my first comment on a post and I don't know the person. Thank you for not only reading, but also taking the time to let me know!

Moving from a corporate restaurant with a large staff to an independently owned pharmacy with a small staff was a huge adjustment. The staff at the pharmacy consisted of JB, the pharmacist; AN, the manager and lead technician;SB, the compounding technician; AP, the clerk; and another student in my class. She quit shortly after I began so she doesn't even get an initial. There were also 3-4 delivery drivers who serviced our store and the other location down the street. The pharmacy is a part of a local chain of independent drug stores. In fact, my store is located a mere 7 miles from one of the locations. Anyways, the drivers were not really involved in our daily interactions.

This may seem like a tangent, but it is necessary to the description of my first day in the pharmacy. As I stated, I work in restaurants in my early 20's. I liked the business, but I didn't meet many people that I truly connected with. You see, I am a geek and an intellectual. I love watching sci-fi, read two books a week, talking politics and social policy, and use to play role-playing games. I found that blending in with the non-geeks was the best course. I had such high hopes for pharmacy school. I thought that smart was the same as open-minded and interesting . I thought I would be surround by great minds and people who wanted to expand their experiences. HA! My class was full of middle-class, vanilla people. I hung out with the woman I car pooled with. We had nothing in common, but we learned about one another. So, I quickly got bored with the people and decided to shake things up a little. I have always been a little bit gothic. I bleached out some chunks of my very dark hair and the dyed them vampire red. I personally think that this should be my natural hair color.

I was hire in September, punk hair and all. My very first day, I had to train on the register with AP. I was annoyed because I wanted to learn how to be a pharmacist not a clerk. It was a fairly busy afternoon. I had met at least 4 delivery drivers. Some guy comes in and starts giving me shit about my hair. He says something about how proud my parents must be and how if I was his child I would not have hair like that. I glared at him and replied sharply that I no longer had to listen to my parents' opinion since I was 27 and paying my own way thru school. Everyone got quiet, but I didn't realize since I was learning the damn cash register. He later introduced himself a KML, the owner. I swear I overheard AN on the phone with him the next week telling him that she had a good feeling about me and wanted to give me a few more weeks. I stayed and eventually won everyone over, but it was a struggle.

I am addicted to reading blogs. I am not sure why I am so fascinated with other people's lives. It is not like my life isn't interesting. I left an 8 year marriage for a short, adorable, sexy, funny woman, cementing my place as the "bad" daughter forever. I graduated from school less than 2 years ago and decided almost immediately to open my own business. I have several friends with lives even more interesting than mine. Why do I read about the lives of strangers? I think I like reading about the daily drama that we all experience. I also like reading about other people's interactions in their work places. I am fascinated with the inner workings of the work place.

Most of us choose a profession without thinking about the environment we will be working in. I worked in the restaurant business for ~6 years. Most restaurant have 20-60 employees. There are distinct divisions within the staff. You have front-of-the-house, back-of-the-house, and management/owners. Front-of-the-house is further divided in hostesses, severs and bartenders. The bartenders tend to think of themselves as something other than front-of-the-house employees, but they are just front-of-the-house employees that make more money. There is often intense animosity between front-of-the-house and back-of-the-house employees. The back views the front as soft, lazy, scammers. The front views that back as a bunch of thugs and lowlifes. As with all stereotypes, there is some truth in both views. I think management plays up these rivalries so no one notices the really crappy way they treat all employees. There was always some underlying drama while we working. I have worked in every position in a restaurant. I loved my job. I was the geeky trainer who followed all of the company rules. People hated me because I expected them to do their jobs. I was well on my way to a career in restaurants when I got pregnant with K.

I decided when I was pregnant that a career in restaurants was not the best choice for raising a family. Prior to my pregnancy, my schedule was something like this--

4:00 pm- Arrive at work 30 minutes early to eat a 1/2 price meal
4:30 pm- Shift meeting or the time when mangers blow smoke up the staffs butt
5:00 pm- 11:00 pm- Wait tables
11:00 pm-12:00 am- Try and get servers to clean up after themselves
12:00 am-5:00 am- Drink lots and lots of beer, play cards with other restaurant workers
10:00 am- Wake up and clean up from the previous night while everyone else slept

Repeat. Sometimes, I would go to work at 11:00 am for the lunch shift. I also only made enough money to pay 1/4 of the rent of a 3 bedroom apartment and my car payment. So I went back to school, but I continued to work in restaurants part-time. After my first year of pharmacy school, I moved and got my first job in a pharmacy. The total staff was 5 people plus 3 students and a few delivery driver. It was a hugh transition from such a large staff. I loved that job and will post several bits about that job later.

It has been a slow day. I am getting the silent treatment from S. She expects me to supply soda to drink as well as lunch items. She has been asking me this week when I was going to buy sodas. I told her that soda was a luxury item and would not be purchased during this time of poverty. So, she showed up with a 20-oz soda every morning this week. Yesterday, I finally broke down and bought soda. This morning, she show up empty handed. I asked her why she didn't stop for a 20-oz today. She told me that she was broke. She hasn't said anything else to me this morning. I do understand being broke. I haven't had a salary since October. I was not able to pay for the past 2 weeks so she feels entitled to my stuff. It is one of the joys of working with family.

I should also say that she makes me laugh at least once a day. I have also been consistently behind in paying her salary. I hope that she comes back after Z is born. My mom is sure that we will have a falling out over this work situation. Unfortunately, my mom is right often. I have to remember that our business relationship is separate from our family relationship. I absolutely hate it when my mother is right.

My wholesaler has become the devil. They drew me in with promises to help during the first few months. I gave them a check for $1,500 on Tuesday. They called me 3 times to make sure I was going to give them the check. I gave it to them yesterday and they called me today to get $1,500 more. Hey, I didn't have money yesterday. Why would I have it today?

The great news is that I got a commitment letter from bank #4 today. They have approved a loan with the terms I needed. They should be able to release the money in 2 weeks. Maybe I will be able to sleep at night.

J was released from the hospital on Saturday afternoon. She is taking the week off to rest.

Prescriptions sales are up this week. Life is better.

Drugs are made by pharmaceutical companies like Lilly and Merek. They are then sold to chain stores and wholesalers in large quantities. As with most products, the more that you buy the cheaper the price. However, it is not practical for an independent pharmacy to large amounts of stock. So, we use a wholesaler. Our wholesaler is located in this state and we get daily deliveries. That means if we don't have something the day that you come in with a prescription we will have it the next day. My wholesaler has been very helpful in opening this store. I have been to the warehouse and met several of the important upper management people. In fact, I have had a couple of meals with the president of the company. They put in my opening inventory and I don't have to pay for it until May. They also financed my computers and my fixtures. They have allowed me have delayed billing. We had our first payment on December 25th. All of these things have allowed me to stay open even without a loan. They are known for fostering the development of independent pharmacies.

This made yesterday even more ridiculous. I knew I was not going to be able to make my payment this week. I debated whether I should call them or let the payment bounce. I call my friend A who worked with me during my fellowship. She has been a technician for many years and has work with this wholesaler the entire time. She told me to call my sales rep and let him know. She mentioned that other pharmacies that she had been involved with had fallen behind and that the wholesaler had been flexible. I did and he asked how much I could pay. I told him the amount and thought that it was done. I get a call 20 minutes later from him. He tells me that I have to get a certified check and also fax a copy of the check to the credit manager. He also tells me that I will have to start prepaying for my future order. So, I am struggling for money and you want me to pay for a check. Also I can't order things for my new patients who bring money into the pharmacy. So much for fostering the development of new pharmacies.

I thought that I would not be able blog much this week, but I have been alone at the pharmacy frequently. I didn't realize how much time J usually spends with me. I spent the night with her again last night. It was a good night. We went to sleep around 11:30 and were only woken once at ~ 5:00 am. Her mom arrived at 7:40 am and we were still sleeping. She has had aggressive respiratory therapy and a couple other treatments that have made a significant difference. It was scary the first couple of days though. When you live with a person with a chronic medical condition who stays in good health, you get lulled into a false sense on security. We have talked about medical power of attorney and other legal stuff, but I felt like we had plenty of time for that later. I guess I should rethink that.

I have debated whether or not to write about my mom. I have a confusing and difficult relationship her (okay, most of us have that kind of relationship with our mothers). I love her and she made me the person that I am. I am frustrated with the way she sees the relationship between J and I. She used to joke when I was in my teens and early twenties that I was going to come out when I was in my 40's. When I fell in love with J, I figured she would be prepared. She has been as nice as she can to J, but there is a caution there that I don't think she had with C. To be fair, maybe she doesn't trust me to maintain this relationship. Anyways, last night I called her to update her on Jennifer's progress. She didn't say to much until I mentioned that K was staying with R & M so I could spend the night. She reminded me that K needed me too and she didn't want there to be jealousy between K & J. Valid point, but if C had ever spent any time in a hospital, I doubt she would be so concerned. I am overly sensitive about all things dealing with K so maybe I am reading into it. All of this goes back to the marriage thing. If we were married, no one would question whether or not I should be at the hospital with her.

There is very little going on at the pharmacy. Prescription sales were good this week.

I spent the night with J last night. She is doing better. I feel worse, but that's what happens when you sleep in a chair in a hospital room. She is in a much less pain. The doctor seemed to think she could get discharged by this weekend. I now can focus on the other major source of stress- money.

I started the process of opening this store by completing a 6 month fellowship with the pharmacy association. I had no financial plan in place. I knew that my idea was solid and that I was a young, Hispanic woman who would have no trouble securing a loan for working capital. I have since found out that no one wants to loan money to a business less than 2 years old. No one cares that I am a minority or a woman. I have a well developed business plan with realistic sales and cash flow projections. I have letters of reference, photographs, an impressive Curriculum vitae, etc. Yet, I am working with my 3rd bank and my loan officer will not call me back. In 4 days, I have a large draft coming out of my account for medications. In 10 more days, I have another large draft coming out for my computers and shelves. I stand by the mail box every day waiting for insurance checks. They usually pay 4-8 weeks after the patients have received their medication. Of course, I knew all of this when I opened my doors. I have really messed up. I believe my loan officer from bank #2 that we would have a loan before the doors opened. I went ahead and open without the money in my account. So if you are thinking about starting a business make sure that you have a loan first. I don't know what will happen when my account is overdrawn, but we will find out on Tuesday.

I will be spending the weekend at the hospital. I will update on J's status as soon as I can.

Yesterday was a difficult day. I went to see J at 5:30 am, 1:00 pm, and 8:30 in the ICU. Much drama occurred while I was working that I am going to leave out of this blog. At 10 pm, she was transferred to a regular room. I was able to help her get settled and I came home to sleep for a couple of hours.

I was thinking about the way gay marriage would affect my life, specifically with this trip to the hospital. There would be no awkward moment each time we moved to a different part of the hospital. She would be my wife and no one would wonder why I there. I would be updated on her status regularly while I was at work. I would be included in treatment decisions, not just informed after the decisions was made. I was given a chance to sign a consent form a couple of nights ago, but I couldn't sign it since I am not a relative or spouse. I know we have all heard and/or experienced this stuff before. Now, I am trying to navigate my way through this without upsetting her or her family. I feel like this is at the expense of myself. I wonder if there would be a "closet" if we were able to get married. I mean can you remain closeted and be married?

I went back over my lunch break. She looked better. I don't think that she will be home before Sunday. Many of her family members are here and plan to stay through the weekend. I offered to let them stay here, but they feel that we are too far away from the hospital. I figure since I am just her "roommate" and can't participate in the decisions that I may as well stay here. I also have a duty to my patients. I have to have some sleep to do my job. I am going to try to stay with her tonight.

J was moved to the ICU at 5 pm yesterday. R returned after picking up some things from me and found J unresponsive. The nurse told R at 1 pm that she was giving J 2 mg of a narcotic. When R returned, the nurse was trying to wake J. J was combative and very confused. They gave her Narcan to reverse the earlier dose and told another nurse that she had given J 4 mg. Dr W was called and decided to move her to a monitored bed. The ICU sucks for several reasons , but mostly because she can only have 2 visitors at a time for 1/2 hour periods of time designated 5 times per day. She is supposed to stay there until they rule out other reasons for her respiratory depression. I went at 6:00 pm yesterday because her nurse promised a visit when she got settled in. They made us wait until the next designated visiting time (8:30 pm). She was much better by that time. I found out that she had been given a different medicine for nausea with the 4 mg than the one she had been given in the ER. She hates that medicine because it does nothing for her nausea and makes her very groggy. I had specifically told the nurse to give her the medication used in the ER. I feel like the staff thought that she was drug seeking and that I was trying to tell them what to do. Anyways, I left and things went to hell.

I stopped in the pharmacy on my way out to talk to JJ. She was my pharmacy school partner-in-crime and a pharmacist on the night shift. She promised to look out for J. I also know several of the surgery residents and they will also be looking out for her.

I am so happy that I just started this blog so I don't have to do the year in review. I did have a nice New Year's Eve, New Year's Day, and day after. I am not sure how much posting I will do this week. J is sick and in the hospital. We went to the emergency room at 2:30 am. I was able to have full access to her and we got in quickly since she is a resident. However, I had to continuously chase down the nurses and doctors for medicine, sheets, and ice. She also was not admitted to a room until 11:00 am. I have never had to try and sleep on an emergency room bed, but looking at it I know it is uncomfortable. When I left at 11:30 am, she was in pain (a 7 on the pain scale) and the nurse promised to get more medication. When I called at 12:30, her mom said that they were waiting until 1:00 pm for more medicine. J never wants pain meds so I know if she asks for medicine she really needs it. Leaving her was absolutely heartbreaking for me. S stayed at the pharmacy this morning and answered the phones. I guess this is the first time I really don't want to own a pharmacy.

R just came by to pick up a few things to take her. I wish I could be there. She said that the nurse said that J's doctor doesn't write for PCA pumps. I find it hard to believe that a specialist does not use the best pain control option available on his patients. Right now they are just chasing her pain and not controlling it. I am worried that this is going to be a long stay.