Back to Blogging

I have not posted anything new on this blog since 2011. I wrote the blog for my employer and stopped working for him that year. But the flurry of activity lately has given me the idea to write again. Even though I don’t work in the pharmacy arena anymore, the issues of healthcare are still important to me. I am married to an NICU nurse who’s in graduate school to become a family nurse practitioner and I help with typing and editing and researching. My personal POV is that healthcare is a mess in America but many of the people who work in it are smart, dedicated and put up with a lot – A LOT – to give the important gift of service that they give every day.
So there’s a lot to think about and a lot to say. Thanks so much for your interest and watch this space!

CVH

Advertisements

A Pharmacist Walks Into a Bar….

I write a blog about pharmacy. So I read a lot of pharmacist’s blogs and from what I read, pharmacists have to deal with a lot of stupid people – customers, managers, doctors, nurses, patients. Not all people in these categories are stupid, of course, but the ones who are seem always to gravitate to the pharmacist. Apparently, pharmacists are whiners. They whine about their jobs, their hours, their customers, their managers. Whine, whine, whine. The Blonde Pharmacist writes, “How many other jobs can you sit on your ass and look at the computer screen all day making sure things are right and make six figures? Not many. Stop whining!!!”

No, I’m not a pharmacist. But I have worked with the public. I’ve always found that outrageous behavior on the part of the public and of my colleagues was normal. Not only that, but the outrageous behavior could be expected to become more outrageous over time. So whine, pharmacists, whine! The absolutely-I-cross-my-heart-and-hope-to-die true stories below show you deserve it:

A pharmacist, wearing his white CVS coat, is waiting for the bus outside a Wegman’s pharmacy that is under construction. A customer is staring at sheets of plastic covering the construction area where the pharmacy used to be. Attached to the plastic is a sign stating the pharmacy’s new location. Looking the CVS pharmacist up and down, the customer asks, “What time is the Pharmacy going to open?” The pharmacist’s mouth falls open. He points to the sign. “Yeah?” says the customer. “How am I supposed to get my prescriptions?”

(Whimper.)

The actor Walter Matthau once said, “I always wanted to be a pharmacist. I liked the way our local pharmacist was always dressed in a nice white coat; he looked very calm. You’d give him money and he’d give you something that you wanted to buy.” Uh-huh. And my mom wore pearls to vacuum the house just like Mrs. Cleaver…..

Speaking of Mrs. Cleaver, calm pharmacy environments and clean white coats are as far gone as my daddy’s 1956 Ford Fairlane: Ring-ring. “It’s a great day at Wright’s Pharmacy! Can I help you?” “Uh – yeah. I – uh…I threw up a little while ago and uhh…well, I threw up my Oxycontin and they’re the ones with the OC on them and uh, I was wondering…is it OK if I take them again?”

(Moan.)

Cut to the guy standing next to the pharmacy counter staring at the plastic pill organizers. Pharmacist: “Can I help you, Sir?” Customer: “Yeah. I lost my seven-day pill box this morning.” “OK,” thinks the pharmacist, “I’ll bite. What happened to it, Sir?” “You see,” said the customer, “I filled my box with all my medications for the week. Then I put it in the microwave and set it on high for five minutes. I do not know why I did that.” The pharmacist is sure that she does not know why, either. “After it dinged, I saw that everything had melted together. I tried to suck up the liquid with a straw, but then the straw melted, too. Now I guess I need a new box to hold everything together.”

Digesting that….uh, yeah, a new box to hold your new prescription for Haldol.

Ring-ring. “Thank you for calling Walgreen’s at Main and Pine. This is Jim. May I help you?” “Where are you located?” (OK, no need to get upset – just count to ten.) ”At the intersection of Main and Pine, Ma’am.”

“Are you open?”

(Sigh.)

A pharmacist is heading down the aisle of the Rite-Aid on his way out for lunch. A customer spots him and grabs his jacket. “Can I get the 12 hour Allegra over the counter?” “Sure,” says the pharmacist. “We have the 12 hour and the 24 hour. Still want to stick to the 12 hour?” “Dunno,” says the customer, looking worriedly up and down the shelves. “What’s the difference?”

!!!!!!

Ring-ring. The pharmacist picks up the phone. “How much is 5 grams in a teaspoon?” asks the woman on the line. Now, this is not a question the pharmacist hears very often. Turns out the woman picked up a prescription for metronidazole vaginal gel but accidentally threw away the applicator. She figured a spoon would work just as well. Thing is, she just didn’t know how much 5 grams in a spoon was. The visual on this was not pleasant – a spoon and a hoo-hoo and all, but since this was a compounding pharmacy the pharmacist offered some free applicators at no charge. Nice recovery.

(Groan.)

Ring-ring. “Thanks for calling Ocean View Pharmacy. How can I help?”

“What number is this?”

(………………..)

A man comes up to the counter. “I need some Naproxen – 500mg.” “Well,” says, the pharmacist, “Naproxen 500mg is prescription only but we have some over the counter in about half that dose.” The man looks blankly at the pharmacist and turns to go down the pain reliever aisle. “How can 500mg be prescription only if you have this on the shelf?” the man shouts. He holds up a box of Tylenol.  The pharmacist gestures the man back to the counter where he explains that Tylenol and Naproxen are not the same thing. “Oh, no,” says the man. “That’s not right. My mother takes Naproxen 500mg and it comes in a bottle just like this and this is what she wants.” “But Sir,” explains the pharmacist, “there is absolutely no Naproxen in this product.” “This is what she wants,” says the man. “This and only this. How much?”

(Whine.)

And then there’s the story of the night pharmacist. It’s 3 am. Ring-ring. “Good morning. May I help you?” Caller (sobbing): “I have some medication I got at the pharmacy *sob* and the instructions say to take it with a glass of water *sob*.” Pharmacist: “Yes, Ma’am, that’s right.” Caller: “I’m so worried! *sob* I took the pill but I only had half a glass of water at the time! *sob* Is that OK?” The pharmacist collects himself. “Ma’am, did you swallow the pill completely or is it caught in your throat?” Caller: “*sob* I think it’s in my belly.” Pharmacist: “Then everything is OK, Ma’am – this time.” Caller: *sniffle* “OK, good night.”

(Yikes.)

Yes, pharmacists – it’s true. You have plenty to whine about. I mean, you can’t make this stuff up! Somebody did make this next story up, though – a little classic pharmacist humor to brighten your day. Egad! You need it!

A lady walked into a drugstore and told the pharmacist that she needed some cyanide right away. The pharmacist, naturally concerned by such a request, asked, “Why in the world do you need cyanide?” The lady explained that she needed it to poison her husband. The pharmacist’s eyes got big and he said, “I can’t give you cyanide to kill your husband! That’s against the law! I’ll lose my license! They’ll throw both of us in jail and our lives will be over! Absolutely not! No cyanide!” The lady reached into her purse and pulled out a picture of her husband in a passionate embrace with the pharmacist’s wife. “Well, now,” said the pharmacist. “You didn’t tell me you had a prescription.”

Happy Dispensing!

(PS – Pharmacists and other health professionals: Do you have a story like this? If so, send it to me at cvh55@apexmedicalplacements.com. We’d love to print it!)

Slouching Toward Compromise – The Access to Birth Control Act

In high school I was a member of the Speech Club and the debating team. One of our favorite topics, both in class and in competition, was abortion – partly because it was emotional and made for lively discussion, but mostly because it was a question that could never be resolved. Now, some 40 years later, abortion is still hotly debated in the U.S. Emotions run higher than ever; doctors who perform them have been murdered. Women who have them have been harassed. Politicians have attempted to make end-runs around the Roe v Wade decision, which made them legal in 1973. But despite all the arguments one thing is sure: the question of abortion is still has no definitive answer.

Enter Representative Carolyn Maloney of New York and Senator Frank Lautenberg of New Jersey. Last week they introduced the Access to Birth Control (ABC) Act to Congress following the release of an Institute of Medicine (IOM) report recommending that birth control be made available without co-pays because of its importance for women’s preventive health care. The Access to Birth Control Act would prevent pharmacies from denying the sale of contraceptives based on a pharmacy employee’s religious beliefs.

Pharmacist bloggers have had plenty to say about the pending legislation. One complained about the tone of the articles he had read about the bill, saying that the organizations supporting it had painted a negative picture of the pharmacy profession. “You would think,” wrote the Redheaded Pharmacist, “there were widespread refusals to fill prescriptions by an entire band of rogue pharmacists if you read these news reports. Painting the picture that pharmacists routinely judge patients or make moral decisions for them at work is simply misguided and wrong!” I’m sure that the Redheaded Pharmacist is right when he asserts that the vast majority of pharmacists don’t mix their personal ideologies with their professional ethics. But his characterization of the bill’s supporting organizations illustrates some of the high emotions surrounding this issue. Not all pharmacists may routinely judge patients, yet the problem of pharmacists refusing access to birth control products is widespread enough to warrant attention by lawmakers. According to the Guttmacher Institute, women in at least 24 states have reported being denied access to birth control and emergency contraception. “The issue of pharmacies refusing to fill prescriptions for contraceptives came to light in 1996,” says NorthJersey.com, “when a pharmacist was fired from a Cincinnati Kmart after refusing to fill a prescription due to her own religious beliefs. Refusals have been documented in 19 other circumstances in several states, including Texas, Wisconsin and Massachusetts.” The problem, while perhaps not routine, is no longer unusual. And the pharmacists involved , while perhaps not a rogue band, are certainly representative of the current political climate in this country – one in which the right of a woman to make decisions regarding her own health has come under attack.

When individual rights are threatened, what is the remedy? The Redheaded Pharmacist, for one, doesn’t believe the federal government should have a role: “I have two words for Rep. Carolyn Maloney and Sen. Frank Lautenberg: state’s rights! The regulation of pharmacies and the requirements of pharmacists to practice should be a state oversight and not a federal issue.” The Roe V Wade decision addresses the issue of state’s rights in this case directly – in 1973 the Supreme Court struck down state laws that made abortion illegal. Legal access to abortion is, in other words, the law of the land. Since some religious views equate contraception with abortion, six states have stepped in with laws that require pharmacies to fill women’s birth-control prescriptions, despite the beliefs of individual pharmacists. But in the end a piecemeal approach to defining the scope of Roe v Wade isn’t practical. Challenges to federal law, whether from individuals or state legislatures, must be met on the federal level.

“This bill is critical because it ensures that every woman will be able to leave her pharmacy with her medication in hand and her dignity intact,” said Marcia D. Greenberger, Co-President of the National Women’s Law Center. The concept is simple – women should be able to walk into a pharmacy and leave with the medication they need. Although the Centers for Disease Control and Prevention included family planning in its published list of the “Ten Great Public Health Achievements in the 20th Century”, the United States still has one of the highest rates of unintended pregnancies among industrialized nations. Each year, 3,000,000 pregnancies, nearly half of all pregnancies, in the United States are unintended, and nearly half of unintended pregnancies end in abortion. Contraception is one of the best ways to prevent unintended pregnancy and reduce the need for abortion.

The ABC Act would require pharmacies to help, not hinder a woman’s ability to access contraception. Should the Redheaded Pharmacist or anyone else believe that the federal government is overreaching, consider this: a report by the Guttmacher Institute reveals that in the first six months of 2011, states enacted 162 new provisions related to reproductive health and rights. Fully 49% of these new laws seek to restrict access to abortion services, a sharp increase from 2010, when 26% of new laws restricted abortion. The 80 abortion restrictions enacted this year are more than double the previous record of 34 abortion restrictions enacted in 2005—and more than triple the 23 enacted in 2010. All of these new provisions were enacted in just 19 states.

While some pharmacists’ kneejerk reaction to the bill may be one of unwanted government interference, the bill actually gives pharmacists something to be grateful for. According to Representative Maloney’s own website the ABC Act protects the right of an individual pharmacist to refuse to fill a prescription by ensuring that pharmacies will fill all prescriptions, even if a different pharmacist has to do it: “By placing the burden on the pharmacy, the ABC Act strikes a balance between the rights of individual pharmacists who might have personal objections to contraception and the rights of women to receive their medication.”

Despite the controversy, the ABC Act is a bright spot in an otherwise dark picture for women’s reproductive freedom. The nature of that freedom will always resist definition because it is highly personal in nature, but this legislation gives us the hope that effective compromises can be reached. It is a reminder from the federal level to pharmacies and patients alike that because we are a nation of laws, and not men, the gulf between diverse positions can be bridged to serve the interests of those on both sides of any issue. Hooray for us.

Problems? Have an Antipsychotic!

If I were to ask you what the single top-selling therapeutic class of prescription drugs in America was, what would you say? Pain relief drugs? GI drugs? Supplements? Nope. The answer is: antipsychotics. According to IMS Health, Inc., “Antipsychotics remained the top-selling class of medications in the U.S., with 2009 prescription sales of $14.6 billion.”

Really? Until recent years I always thought antipsychotics were hard-core drugs reserved for serious psychiatric diagnoses: schizophrenia, bipolar disorder, delusions, hallucinations and thought disorders. Today it seems everyone is being prescribed these drugs – unruly kids, elders with dementia, and the average working person suffering from too much stress. Just about everyone knows someone who is on one of these drugs because our medical and educational systems make it difficult to refuse them. My partner’s son, for example, was precocious, too quick for the pace of his teacher’s lesson plans and bored in school. So he found ways to entertain himself, as bored children will tend to do. The school administration branded him with ADHD and demanded that he be put on Ritalin or be expelled. He was snatched out of that school in a heartbeat and sent to a boarding school in his parents’ native Britain where the answer to every behavioral issue was not necessarily a pill. Today this problem child is a happily married father of three with a degree in physics and a job in the aeronautical field. The option of alternative schooling is not open to every parent, however. Another child I know may not fare so well. Suffering from insomnia, he wandered around the house all night. So his mother took him to a pediatrician and got talked into a diagnosis of bipolar disorder. The last time I saw him he sat at the table staring out from behind wide, blue eyes, strangely quiet and seemingly devoid of emotion. No doubt he’s easier to manage. He’s six.

Little wonder we’re using drugs more often to address difficult behavior problems – the pharmaceutical industry developed a new class of medications in the 90’s known as “atypical antipsychotics”. Zyprexa, Risperdal, Seroquel and the more recent Abilify are hyped as more effective than old-school drugs like Haldol and Thorazine. And they don’t cause tremors. AlterNet.org calls the atypicals the “bright new stars in the pharmaceutical industry’s roster of psychotropic drugs – costly, patented medications that made people feel and behave better without any shaking or drooling.” By 2009 Seroquel and Abilify were number 5 and 6 in annual drug sales, with 20 million prescriptions written for the top three atypicals.

Maybe the U.S. is suffering from mass psychosis. Or maybe the cause of the explosion in antipsychotic use isn’t about psychosis at all. It’s not news that drug companies woo physicians into prescribing their drugs with gifts, junkets, and money for research. Psychiatric treatment is subjective. There’s no biological test for mental disorders and with all the influence from Big Pharma, of course the treatment of choice has become chemical in nature. Add to that the fact that health plans won’t pay for traditional therapy anymore and it’s eay to see why a shocking 389,000 children and teenagers were treated last year with Risperdal alone. Of those, 240,000 were twelve or younger. Twelve. Most of these kids had been diagnosed with attention deficit disorder. Research in the Journal of the American Academy of Child & Adult Psychiatry found that the number of children five years and younger – some as young as two years old – receiving antipsychotic meds has doubled in recent years. These are some of the most powerful and dangerous drugs in the drug industry’s arsenal: antipsychotic drugs that in most cases are not even approved for use in children.

Sickeningly, a 2009 study in The New England Journal of Medicine found that 18 out of 20 psychiatrists who wrote the American Psychiatric Association’s clinical guidelines for the treatment of depression, bipolar disorder and schizophrenia have financial ties to drug companies. Mental illness is now the leading cause of disability in children because under Big Pharma’s influence the criteria for mental illness have simply been expanded so almost everybody has one. The over-prescription of antipsychotics amongst the elderly is as troubling as over-prescription in kids; neither group makes its own choices about what drugs to take. Their vulnerability makes them targets to be tranquilized when they have problems. Alternative treatments, on the other hand, require an investment of time and thought. And health insurance plans, including Medicare and Medicaid offer little in the way of coverage.

Increasingly, psychiatrists are moving away from cognitive therapy and into medication management. Insurance companies DO pay for that. But medications don’t solve behavioral problems, they just slow down the person who takes them. Children don’t always fall under the category of a pervasive developmental disorder. Rather than risking the health of these kids and incurring the long-term cost of the damage these drugs can cause, health plans should audit physicians to see if the meds are needed. And here’s an idea: compile guidelines for diagnosing and treating mental illness on the basis of an objective review of scientific evidence – not on whether the shrinks writing them get speaking fees from Eli Lilly or an ego-stroking award from Merck.

Happy 4th of July!

I’m moving to a new house this week and you know how that is! So I’ll return with more pharmacy news and views in a couple of weeks. In the meantime, here’s some Independence Day wisdom to fill the space. Have a wonderful 4th of July from all of us here at Apex Medical Placements! -CVH

You have to love a nation that celebrates its Independence every July 4, not with a parade of guns, tanks, and soldiers who file by the White House in a show of strength and muscle, but with family picnics where kids throw Frisbees, the potato salad gets iffy, and the flies die from happiness. You may think you have overeaten, but it is patriotism.
Erma Bombeck

Better to starve free than be a fat slave.
Aesop

I have always been among those who believed that the greatest freedom of speech was the greatest safety, because if a man is a fool, the best thing to do is to encourage him to advertise the fact by speaking.
Woodrow T. Wilson

Liberty means responsibility. That is why most men dread it.
George Bernard Shaw

Patriotism is the last refuge of scoundrels.
Mark Twain

There, I guess King George will be able to read that.
John Hancock, after signing the Declaration of Independence

Immigrant Picnic

By Gregory Djanikian b.
1949 Gregory Djanikian

It’s the Fourth of July, the
flags
are painting the town,
the plastic forks and knives
are laid out like a parade.
And I’m grilling, I’ve got my
apron,
I’ve got potato salad,
macaroni, relish,
I’ve got a hat shaped
like the state of
Pennsylvania.
I ask my father what’s his
pleasure
and he says, “Hot dog, medium
rare,”
and then, “Hamburger,
sure,
what’s the big
difference,”
as if he’s really asking.
I put on hamburgers and hot
dogs,
slice up the sour pickles and
Bermudas,
uncap the condiments. The paper napkins
are fluttering away like lost
messages.
“You’re running around,” my mother says,
“like a chicken with its head
loose.”
“Ma,” I say, “you mean cut
off,
loose and cut off   being as
far apart
as, say, son and daughter.”
She gives me a quizzical look
as though
I’ve been caught in some
impropriety.
“I love you and your sister
just the same,” she says,
“Sure,” my grandmother pipes
in,
“you’re both our children, so
why worry?”
That’s not the point I begin
telling them,
and I’m comparing words to
fish now,
like the ones in the sea at
Port Said,
or like birds among the date
palms by the Nile,
unrepentantly elusive,
wild.
“Sonia,” my father says to my
mother,
“what the hell is he talking
about?”
“He’s on a ball,” my mother
says.
“That’s roll!” I say, throwing
up my hands,
“as in hot dog, hamburger,
dinner roll….”
“And what about roll out the
barrels?” my mother asks,
and my father claps his hands,
“Why sure,” he says,
“let’s have some fun,” and
launches
into a polka, twirling my
mother
around and around like the
happiest top,
and my uncle is shaking his
head, saying
“You could grow nuts listening
to us,”
and I’m thinking of pistachios
in the Sinai
burgeoning without
end,
pecans in the South, the
jumbled
flavor of them suddenly in my
mouth,
wordless, confusing,
crowding out everything else.

Certainly, Sir. Would You Like Fries With That?

I went to my friendly neighborhood Walgreen’s the other day to pick up my prescriptions. I like this store because it has a drive-through. As I watched some schmo in the car ahead of me annoy the pharmacist from the safety of his front seat something occurred to me. No wonder pharmacists are complaining about getting no respect. Silly pharmacists – drive through’s are for hamburgers!

Think about it. McDonald’s: front counter, drive-through area, French fry station, hamburger station, set-up/prep station, etc. Maybe 1 or 2 people staff each station.

Your local chain pharmacy: front counter, drive-through window, data entry station, fill station, verification station, etc. Maybe 1 or 2 people staff the whole operation! But the schmo ahead of me is thinking: McDonald’s drive-through – fast food. Walgreen’s drive-through – fast pharmacy. He’s waving his arms wildly now and yelling at the pharmacist so he can be heard through the bullet-proof glass because those microphones in the clown’s mouth at the burger place never work. He just doesn’t get why he has to come back for his Simvastatin, Cialis, Norvasc, Xanax order. He doesn’t have to come back for a Big Mac!

What we have here is a bad case of fast food mentality. The boys in the front office created it. The schmo ahead of me caught it. And there’s no pill behind the glass that can cure it. You see, this guy probably came through and shoved four bottles into the drawer from a mail-order pharmacy. He wants to transfer his prescriptions to THIS pharmacy. He doesn’t want to wait. That’s why he came to the drive-through. Drive-through = fast food, or this case, fast pills.

OK.
First the pharmacist has to call the mail-order pharmacy. That’ll be 15 or 20 minutes, IF all goes well. In addition, the guy has new insurance. It’s three o’clock on a Friday afternoon and he’s going out of town this weekend. After 18 minutes of waiting on hold, the pharmacist is relieved to find that the mail-order scripts still have refills available. So he runs the first one with the new insurance…..it’s not covered. He explains to the guy that there are some generic refills available – maybe they will be covered. Schmo responds with much waving of arms and a sock to the steering wheel for emphasis. “Why can’t you call the doctor right now and get that prescription straightened out?” wonders Schmo. Sweat appears on the pharmacist’s brow. The phone is lit up. There’s a woman coughing discreetly at the counter. One tech is out sick. The other one wants his break. The pharmacist notices the other prescriptions are covered, but the co-pays are pretty high. He doesn’t have enough medication to fill the whole thing. Schmo blows a gasket over the prices. And so it goes…..

“Hey, Schmo,” I think to myself as I imagine the details of the drama unfolding ahead of me. “Get a grip!” That pharmacist behind the glass is NOT equal to the hamburger guy who slaps pickles on your bun at McDonald’s. He has at least a dozen other responsibilities and six other customers besides you and the health and well-being of all of you depends on the quality of his work. So can the attitude. And tell me something. Why on God’s green earth would you wait until three o’clock on Friday afternoon to fill prescriptions with NEW insurance when you’re leaving town in a couple of hours? And by the way, chewing out the pharmacist over prices is like harassing the waitress over the cost of your meal. Your prescriptions are expensive and he can’t write out new ones. If you want the cheap stuff, call your doctor. And here’s a clue: PICK UP THE PHONE
AND CALL AHEAD. If you had, your doctor could have been contacted and the right drugs could have been ordered.

Yeah, I know. It’s the staffing, stupid. If the suits at CVS and Rite-Aid and Walgreen’s want drive-through windows for those with fast-food mentalities, then they need to staff accordingly. They probably aren’t going to do that any time soon, but that’s a subject for another blog. In the meantime, when getting your prescriptions filled at your local pharmacy, use your head. Know your meds. Understand your insurance. This is your health, so take some responsibility for it. And dang it, Schmo, I know both guys behind the glass are wearing white coats, but applying condiments to your sandwich is simply not equal to double-checking your drug order for dangerous interactions. Those heavy-duty prescription medications you’re on have the potential of really messing you up if  your pharmacist doesn’t get it right. So think about it, Schmo. Do you really want it fast? Or do you want it good?

Please Pass the Tissues – Then Shoot Me

Drip. Wipe. Blow. Sneeze. Repeat. This seems to be the reality of many of my neighbors here in the state of New Mexico. As I peruse the bedding plants and sacks of fertilizer in my local home store I shuffle my feet to the “Hack, hack, tweet, tweet!” of the Springtime Serenade. Red eyes and noses appear above the shelves of fish emulsion and snail bait while multi-colored handkerchiefs flap in the dusty breezes of the garden department courtyard. Ahh! It’s another beautiful May in the desert. Allergy-ridden horticulturists, hell-bent on having beautiful yards, no matter what the cost, stuff their SUV’s with the bags, buckets and boxes of their unfortunate demise: flowers. Grasses. Trees. POLLEN!  

 Checking the pollen count for Albuquerque I find the count for trees is – HIGH! The forecasted pollen levels for trees is – VERY HIGH! Summer is just around the corner. Those HIGH! pollen levels for grasses are sure to follow. And then we have VERY HIGH! pollen levels for weeds to look forward to! Would-be gardeners will honk, wheeze and scratch themselves to the corner drug store, creating a bonanza for the makers of allergy remedies like Zyrtec, Allegra and Claritin. Irritants like grass and tree pollen stimulate the immune system to release histamine, causing the familiar itching, sneezing, runny nose and watery eyes. According to the American Academy of Allergy, Asthma and Immunology, seasonal allergies result in 12 million physician visits a year and $11.2 billion spent on treatment. No wonder. Seasonal allergies are miserable. People who suffer from them will do nearly anything for relief. A friend of mine from my college days has terrible allergies. She appears to have a cold all the time. A really bad cold. We graduated from college in 1978. If I had had a really bad cold since 1978 I would be swallowing every pill and potion I could get my hands on for some relief. There are all kinds of medications on the market; some 35 are available OTC, another 28 by prescription. There are antihistamines, decongestants, anticholinergics, corticosteroids, leukotriene modifiers and mast cell stabilizers. There are sprays, drops, pills, and liquids. Some can raise blood pressure, cause insomnia or drowsiness. Others may cause diabetes, osteoporosis or glaucoma, lead to skin rashes, fever, heartburn and headache.  But according to a 2005 survey conducted by the Asthma and Allergy Foundation of America, more than half of respondents said they were “very interested” in finding a new medication. One in four reported “constantly trying different medications to find one that works for me.”  Why is it so hard to find an effective treatment?

Allergic rhinitis, or hay fever, as it is commonly known, isn’t taken very seriously, either by physicians or allergy sufferers themselves. There are 50 million people in the US with allergic symptoms severe enough to warrant treatment, but four out of five never make it to the doctor. Instead they rely on OTC remedies. A patient may try one antihistamine and if it doesn’t work try another, when what they really need is a decongestant, or a drug that targets another part of the allergic reaction or a steroid. There’s no treatment plan in place and they suffer needlessly. In reality, seasonal allergies are nothing to sneeze at. Allergies can lead to sleep problems and set sufferers up for more serious respiratory problems. Children with allergic rhinitis are three times more likely than their non-sniffling counterparts to develop asthma. Kids and adults alike are more likely to develop sinus and ear infections, especially if their allergies go untreated. There are lots of medications these days that can help and some of the newer ones have few side effects. And there are things people can do to lessen their need for medications or even do without them altogether. The following steps can lead to a reduction in the irritants that cause allergic rhinitis:

1.      Check your local pollen forecast. See what kind of allergens are in the air as temperatures get warmer.

2.      Try to make your bed as allergen-free as possible. Dust mites (eww!) hide in old bedding and mattresses. Vacuum your mattress. Use a mattress cover. Wash and replace bedding often.

3.      Get rid of the carpet. Have you ever taken up an old carpet and seen what’s underneath? Believe me, you don’t want to be breathing that stuff. Hard floors are much easier to keep clean.

4.      Wear big sunglasses. Do your best Jackie O impression. On a windy day you’ll keep pollen out of your eyes.

5.      Give your pup a bath. Your cat, too. You’ll keep their dander down and have less dirt in the house.  

6.      Exercise in the evening. On high pollen days you can choose to run, walk or bike in the evening, when counts are lowest. Shower when you come in.

7.      Use HEPA filters. High-efficiency particulate air (HEPA) filters can be used on vacuums and vents. They trap allergens.

8.      See your allergist. He can dig deeper if OTC or home remedies don’t help. You may need a prescription drug or even allergy shots.

One more thing – I’ll let you all in on the miracle potion that helped with seasonal allergies around my house. My significant other was truly suffering from a dry, allergic cough which made existence generally wretched. So I did a little research on home remedies and rediscovered a tried-and-true concoction: a nice cup of chamomile tea with some fresh lemon juice, some raw, local honey and a wee bit of bourbon. It’s worked wonders. Just sayin’.