With the bazillions of dollars that Big Pharma pulls in you would think that there would be plenty of money for making the drugs that are widely prescribed throughout the country. I only wish that were true. I guess it is going into the coffers of the CEOs, CFOs, SVPs, and SOBs instead.

Once again, community pharmacy staffs across the country are taking abuse for not having drugs in stock. Once again, this is not our fault. I made a tablet in a History of Pharmacy wet lab. Notice the word “history” in that sentence. While I can throw together a cream, ointment, emulsion, suppository, or a capsule, we don’t make tablets anymore. Manufacturers manufacture, dispensers dispense, and we like it that way—provided that the manufacturers do their job. I don’t know what the problem is, but they haven’t been.

If you want to have a bad day, try telling a professional oxycodone ingester with a case of the fits that we don’t have the 30 mg. tablets that make up his outrageous 180 mg. total daily dose, and we can’t substitute with other strengths because, a) It’s a narcotic, and it’s against the law to do that, and b) Even if your doctor agrees to issue another script, Big Pharma isn’t making those strengths either. We also get to say that not only do we not have the drug, but we don’t know when we will be getting it. I never get accused of having the drug and not wanting to fill the prescription because I think the patient is an addict. I never get told to go into the corner and go fornicate myself, or have my parentage questioned by said patient. Never happens.

It’s not just opiates either. We went about four months without a single brand or generic Ritalin tablet, and only recently has the generic started to trickle in. Sustained-release metoprolol succinate (Toprol) is one of the most popular blood pressure medications in the country. With low side effects and once-a-day dosing, it is a fantastic drug. We went about four months without a single tablet of any strength and had to scramble to convert a bevy of patients to other medications, risking new side effects for no reason other than Big Pharma is putting personal profit ahead of production. They are compromising patient care; shame on them.

I slept through most of my macroeconomics classes, but I remember supply and demand. When I’m dispensing 500-1000 of a tablet every week, I would imagine that other pharmacies are doing the same. That creates demand as far as I remember. Actually, I learned that in 8th grade and, before that, on “School House Rock.”

Apparently, ridiculously paid Big Pharma top brass can’t grasp concepts a six-year old knows and keep supply lines open. They don’t realize that they are compromising patient safety. Someone needs to explain it to them. I volunteer.

Jay Sochoka, R.Ph. dreams of a Utopia where partial fills don’t exist and tablets never go out of stock.

My son Julian is the most trusting kid I know. Due to his ADHD, he is sometimes rash when making a decision, putting him a dicey situation. I have a genuine fear that some kid is going to have a bad idea, and Julian, seeking his acceptance, goes along with it. This is how a kid winds up on drugs. This scares the absolute life out of me.

As a kid, I was arrow straight. I went to a party or two with alcohol present but didn’t drink at one until New Year’s Eve senior year. College was a different story. With newfound freedom, I got high with a little help from my friends. In fact, I never met a drug I didn’t like. I never did heroin. I knew I’d like it too much and now I’d either be dead or buying my needles 10 at a time. Nobody wants to see their kid in that position.

There are two reasons that I have confidence that my kid will never put an intoxicant into his system. First is his mother. Sheryl NEVER even took a drag on a cigarette and only got drunk two or three times in her 20s. In fact, my wife has not used any alcohol, except for cooking, in well over 12 years. She sees my past as the thing that antichrists are made of and imparts that sentiment on the boy. Second is Iowa State University’s Strengthening Families program.

Penn State Worthington runs this seven-week program in school districts throughout the area. North Pocono is one of them. The program teaches kids how to develop healthy social relationships and avoid peer pressure. It teaches adults how to “show love and set limits.” In short, if your kid does drop a bomb in your lap, it teaches you how to handle it well.

Sessions begin with dinner, after which families break into three groups. The adults go with Mrs. Carol Hemphill whose reputation as a teacher precedes her. The adolescents (ages 10-14) go for their instruction, and the youngsters have child care provided for them. Parents discuss their kids in large and small groups, and watch DVDs, where Mike and Carol scold Bobby for not texting when he was running late in a wrong way/right way format. Kids develop their skills through socialization and role-playing. After an hour, parents and adolescents are reunited for an hour of highly enjoyable family activities. It makes for an awesome night.

The cost you ask? Nothing. Zero. It is funded by grants. The next session will begin at NPI in mid-February. If you have a 10-14 year-old, I highly recommend the program. If you want to read more about it, go to www.extension.iastate.edu/sfp/index.php, or, better yet, call the program director in this area, Karen Thomas, Penn State Extension, 570-963-6842, or e-mail her at kat1@psu.edu. The Strengthening Families Program can’t survive without grant support—or your community support. It is worthy of funding and community involvement, because it teaches skills that could save the parent-child relationship in a time of crisis, as well as your kid’s life. Peace.

Jay Sochoka, R.Ph. wants the best for his family and yours too.

“If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”
Charles Dickens
A Christmas Carol

The words of the 1843 classic are reverberating throughout Harrisburg. The budget for the pharmacy section of Access has been slashed and burned, and Governor Tom Corbett is micturating on the ashes. Keep in mind, the majority of the state voted to put a “sea of red” into office, so a sea of red (ink) you are now going to get.

The administration of the Commonwealth has seen fit to limit the number of prescriptions per month that a patient can get to six. I have seen drug regimens with 15-25 plus drugs in them. The bottom line is out-of-pocket costs for a high-maintenance patient could be staggering. The decision of medication or food is going to become a reality for many patients, and, to put it bluntly, people are going to die because of this. (But if they are to die…)

The administration, however, is not without a heart. The restriction is lifted on people under 21 (I can’t say children due to the age range), pregnant women, and those living in a nursing home or other intermediate care facility. No one wants to be involved in a fetal demise or death-of-a-child lawsuit. Prior Authorizations can be approved for medications that are life-threatening (i.e. insulin) when not taken. Good job to the lawyers for figuring out that one. I am frankly shocked about the nursing home exception. I didn’t think the administration would even see them as human. (…and decrease the surplus population.)

Pharmacy staffs across the Commonwealth are “thrilled” with the decision. Although a letter was sent in December, apparently many people didn’t read it. Either a pharmacist or tech has to deliver the news that some of their prescriptions are not between 0-3 dollars, and there is nothing we can do about it. The messengers are being shot, and pharmacy staffs are taking a lot of heat for this. It is highly unappreciated. This was not our idea.

One way to curb Medicaid expenses is to crack down on fraud and unnecessary cases. When a known drug dealer pulls up in as Escalade and whips out his Harrisburg Gold Card, I am offended. When a doctor with good insurance has a kid with a chronic illness and has Access to pick up the highly affordable, in-their-tax-bracket copays (and they drive a Lexus), it irks me. Both of these scenarios have happened in my career. I can’t believe agents don’t investigate such cases.

There’s a silver lining for pharmacists. We can use our Medication Therapy Management skills to streamline drug regimens. We can reduce costs if you allow us (pay us) to put our skills to work. In the long run, it will save you money. Thank you, Governor Corbett, for this disaster. Remember, Pennsylvania residents, the majority of you voted for this. Peace.

Jay Sochoka hopes the Three Ghosts will visit the “Governor” sometime soon.

So…it recently came out that Paula Deen was diagnosed with diabetes a few years ago. Really. So surprising. How could someone with such a healthy diet possibly be stricken with diabetes. Notice there are no question marks or exclamation points in those sentences.

For those of you who don’t watch Food Network, the “Butter Queen” Paula Deen is a Southern-based comfort food Jedi. The South cooks like they are still working the farms with nothing more than a rake, a shovel, and an iron will. Deep fat frying and copious amounts of saturated fat are trademarks of the dishes. When she wants to lighten a recipe, Mrs. Deen uses butter instead of lard.

Well-known Chef Anthony Bourdain, never afraid to convey his feelings, referred to her as “the most dangerous person in America.” When a stick of butter or more is required in a recipe, it is referred to as a Paula Deen of butter. Mrs. Deen has done something with her Type II (insulin dependent) Diabetes that few people have done. In the same vein as Wilford Brimley, she has turned a chronic disease into a lucrative contract.

The nickels and dimes were right, so Paula Deen now endorses Novo Nordisk’s RNA origin insulin analog, Victoza (a poor seller due to its outrageous cost and lack of pharmacy insurance formulary appearances). I guess they see this as their shot of launching the drug into Rock Star status. With the endorsement and the right amount of “incentive” to the insurance companies, it just might work.

Diabetes is a pervasive disease that affects a whole lot more than the pancreas. Untreated and over time it can cause kidney failure, blindness, coronary artery disease due to high cholesterol, amputation due to bad skin ulcerations that won’t heal, and, eventually, death. The pancreas is only going to make so much insulin in a lifetime. Abuse it for too long, and you are going to wind up on an oral medication like glyburide and metformin which prod your pancreas to squeeze out a little more juice and coax your body’s insulin receptor cells to be more receptive to what your body is making. Abuse it a little longer and you will become a slave to finger pricking and needle sticking. To paraphrase my guru, Master Yoda, once down the diabetic path, forever will it dominate your destiny.

There is a ray of light in that dark cloud. The destructive effects of diabetes can be held off indefinitely through good glucose control. In Type II Diabetes this is achieved through the proper insulin regimen and, equally as important, smart diet and regular exercise program. Judging by pictures of Mrs. Deen, she could do better in both departments.

This is where I once again offer my services. Paula, I am a hardcore foodie who loves his butter but has learned a thing or two about moderation. I would make a fabulous online coach for you. We can write The Paula Deen Diet together. Peace.

Jay Sochoka, R.Ph. does not want Type II Diabetes…ever.

As I said last week, the Presidential level of politics has a three ring circus with fire juggles and breathers going full throttle. The Republicans are doing such a good job of beating each other up, that the Obama administration just has to watch the mass destruction and save its campaign cash until midsummer. I watch the debates just to witness the red meat get thrown. There is nothing quite like a Presidential election year in politics. Like the Olympics, it happens every four years and you miss it during the other three.

Let’s look at who’s left in this political demolition derby:

Willard Romney is the clear front runner that nobody really likes. He is the safe candidate for the Republicans and, while conservative from a Democrat’s point of view, he is a moderate by the hard right’s standards. Since Massachusetts, under his watchful eyes, actually created the model for the Obama administration’s Affordable Care Act, the conservatives of the party view this as a mortal sin and a huge flip flop by the Governor. He’s also mean to dogs. I’m not just saying that; he put his Irish Setter in his crate, put the crate on top of the car and drove to Canada from Massachusetts. The dog defecated itself in fear. Nice guy.

Newt Gingrich divorced one of his wives while she was on her death bed. I would think the leader of the free world would require a little more compassion. He also took between 1.6 and 1.8 million from Freddie Mac when he acted as a “historian” (read lobbyist) for them. The right despises such institutions. Anything that gives someone a chance to get out of their parents’ basement and make a life for themselves is surely the product of dangerous thinking and must be dealt with severely. Working for them can only be viewed as an egregious error in judgment.

Ron Paul reminds me of the relative that you don’t want to invite for Thanksgiving, but you do to save an argument. Once they get there, you have to deal with what comes out of their mouth for the duration. What you hear is a combination of comedy, offensiveness, and sheer insanity. Essentially, he’s the Republican equivalent of George Carlin with a House seat. He is Libertarian, so some of his views (his support of drug legalization) are so conservative, that it’s liberal. In theory, he could take the college vote away from Obama, but he is too old and too nutty to ever get the nod.

The two Ricks should just save everybody some money and bow out now. Governor Perry makes George W. Bush look like Stephen Hawking and Rick Santorum is too conservative for his own good. The first time I remember voting for a Democrat was when I voted for Bobby Casey to knock his royal arrogance out of the Senate. A vote well cast, if I say so myself.

I see Willard getting the nomination, but not without a lot more political bloodshed. From now to November, this is going to be fun, and, at times, horrifying to watch. Peace.

Jay Sochoka, R.Ph. is glad that he’s not running for President.

Senate Orator: “All fellow members of the Roman Senate hear me! Shall we continue to build palace after palace for the rich? Or shall we aspire to a more noble purpose, and build decent housing for the poor?”

Entire Senate: “£¥€}< THE POOR!"

Senate Orator: "Good!"

The sentiment of self-fornication from the “Roman” Senate in History of the World Part I has bled its way from the poor of the 70s to up to the middle class today. It is clear that the Congress is out to protect the interests of the people, provided that you share the view of Willard Romney that “corporations are people, my friend.”

A Facebook friend, who usually nauseates me with his ultra-conservative, Constitutionalist view, had a point worth repeating. He would like Senators and Representatives to wear NASCAR-like uniforms with their corporate logos proudly displayed on their bodies so we can see to whom their campaign funds are beholden. Simply brilliant.

I would like to add to that. I think the official seals of both Houses should replace the eagle with another bird: the middle finger. I feel it would purvey the true sentiment of the Congress. The disconnect between the powerful and the powerless has never been so great. I feel that if I were drowning, the county, state and national public officials, who I may have voted for and whose salary I pay with my taxes, would be happy to throw me a cinder block. I hear people say, “I’m going to write my Senator about that!” Unless you have a check made out to their PAC, I wouldn't expect an answer anytime soon.

The only Commissioner I even felt reasonably good about voting for was Pat O’Malley. That’s right; I voted Republican. I have met and talked to all three County Commissioners at one point or another. I even had a really good cheeseburger at Comissioner Wansacz’s bar, JW’s. Mr. O'Malley was the only one who I felt had a genuine personality about him. Misters O’Brien and Wansacz both feel like double-talking-think-of-every-word-you-choose-thrice politicians. They both have their degrees in BS Artistry.

When Mr. Wansacz was being interviewed by WILK’s Steve Corbett after being cited for taking a leak in an alley after a football game, I felt dirty from his answers. He said it was a guy in the group, and he was just there. I’ve been in the situation of a group guys who had too much to drink, have really full bladders, and one of them decides to water the building wall. All of a sudden a chain gang forms, because the tinkling sound makes everyone feel like they have to go. He couldn’t man up and give a straight answer. It took three minutes to answer a yes or no question.

While this level of government is entertaining, the Presidential level has fire jugglers and breathers working full throttle in all tree rings—more on that next week. Peace.

Jay Sochoka, R.Ph. is dying for a commentator spot on MSNBC.

The tree is down, Auld Lang Syne has been sung, and the time for New Year’s resolutions is at hand. With all of the holiday eating and weight gain, there is the wailing, gnashing of teeth, and rending of garments in Biblical proportions. I am among that rabble. I lost a few pounds after my shoulder surgery, but, since Thanksgiving, I have been “eating stupid.”

That needs to end before I run into real trouble.

I need to lose about 30 pounds. I can’t believe that I put myself in this position. The absolute killer on the roads of Northeastern PA and beyond is long gone. While I have total respect for those out there, especially Samantha Snead, who absolutely destroyed the Steamtown in her debut taking second overall in the female division, I just have no ambition to put my right foot in front of my left at a high turnover rate for hours on end anymore. I need to get that back.

This is the plan. Santa gave me a membership to the Marywood University Mellow Center for Athletics and Wellness. It is an absolutely world-class gym with an Olympic-sized pool. It is so green that the wind assists in the generation of power for the facility.

The magic word in the description is pool. I love to swim. I am instantly transported to Newton Lake the second I hit the water. I can stay in there for two hours and not get bored. Swimming is the best exercise on the planet. It is super challenging cardio and genuine total body muscle sculpting all at the same time—a complete two for one.

It will not be enough though. I HAVE to lift weights. After the weight loss and the loss of muscle mass (not to mention that extra 30 pounds), I look alike a deflated balloon with my shirt off. There is a good reason why I wear a wetsuit all summer long when I am lakeside. It is a man corset—lift, separate, and pull-in all at the same time. I am going to attempt a shirt-off body at age 40 with some severely stretched skin.

I will also start running again. I want to get Julian running 5Ks this year. He is showing a lot of promise: 10 years old and 64 pounds with my stride. He will be putting his black and red Under Armour that Santa brought him to good use. I will be chasing after him around the yard and track and working out by myself.

Whoever said your ability to lose weight changes at 40 hit it dead-on. This is going to take a while. If all goes well, I should be markedly improved by early June. If you are in the same boat, stop by to see me, and I’ll talk you through it. Peace.

Jay Sochoka, R.Ph., refuses to go up another size.

Christmas, Hanukah, Kwanza, Winter Solstice, and New Year’s are the traditional holidays of the season. But do you recall the most famous holiday of all? Two days after Christmas Day is Brian Wilson Day. While this is not yet a national holiday, it is my goal to make it one.

Brian Wilson Day is named after the ingenious, and troubled, Beach Boys songwriter who spent a year or two straight in his pajamas. He never left his house and just lolled around in his PJs. He also gained about 100 pounds due to his inactivity.

Since we only honor him for the day, we will not gain as much weight, but one to two pounds may be added to the abdominal area. On Brian Wilson Day, we get dressed up. By that, I mean we put on clean pajamas. We head to my aunt’s farmhouse, where we gather with the rest of the family revelers (or slackers—I can’t decide which; it’s all good on Brian Wilson Day).

We then proceed to eat Christmas leftovers, watch movies, and take naps all day long. While sloth and gluttony are two of the seven deadly sins, they are my favorite. If they are indeed sins, I do not want to be a saint. I’m pretty active throughout the year so I allow myself the time to rest completely. Everybody should. A long winter’s nap should be on everybody’s list of things to do during the holiday break.

Brian Wilson Day was years in the making. For about ten years, my Mom, Aunt Evelyn, Cousin Michele, and I all fantasized about a Christmas Day when we would wake up in our pajamas and never get out of them. Due to in-law family commitments, it could never happen. We came up with the next best thing. The first day my work schedule allows, PJ Day (as it is also known), happens. As much as my family loves Christmas, we also cherish PJ Day. As we part company after Christmas Eve, we are already looking forward to getting back together.

Soon enough, the time will come to make a resolution to lose some weight or modify your lifestyle to a healthier one. Brian Wilson Day is not that day. I encourage you to celebrate the day between now and January 3rd when the kids go back to school. Be lazy and commit piggery of the highest degree.

In this hustle and bustle season, which seems to get busier every year, you need to tune out for a day. The time for serious work will be here soon enough. Write your senator and congressman. Make Brian Wilson Day happen for everyone. Shut down the entire country for one day, with no expectations other than rest and relaxation. We all could use it. Peace.

Jay Sochoka, R.Ph .thanks Brian Wilson for his musical and holiday contributions.

“Christmas! Wonderful, glorious Christmas around which the entire kid year revolves.”
-Jean Sheppard, A Christmas Story

As I said last week, I am a huge fan of Christmas. I immerse myself in the holiday season.

I have my mother to thank for my love of Christmas. She made it special from my first memories. (Thanks, Mom.) I am unabashedly Slovak, and our Christmas Eve celebration (the holiest night of the year) is about the birth of our Lord first, family second, and presents third. My core family and their offspring have been gathering for decades. No one has missed a Christmas Eve since I have been alive. I don’t want to be the first one to do it. Here is a tradition that I will share with you and you may feel free to adopt.

In our celebration of prayer, Scripture reading, sharing of Oplatki (holy wafers) with garlic and honey (to remember the bitter and sweet of life), we have the apple. We take the apple (now apples, due to the size of the family [I suggested we use a watermelon]) and cut it into as many pieces as there are people at the table. We then take that piece and slice it according to the number of people at the table, and give one of our pieces to each person, while taking a piece from them. The lesson here: If you are ever lost or in trouble, you think of those with whom you shared the apple and go to them for help. The night my Dad died, I called my cousin Michele, who I refer to as my first slice. She called everybody else. It’s what we do.

It is also important to remember why we celebrate. (Get the voice of Linus Van Pelt in your head.)
“And there were in the same country shepherds, abiding in the field, keeping watch over their flock by night. And, lo, the angel of the Lord came upon them, and the glory of the Lord shone round about them! And they were sore afraid … And the angel said unto them, ‘Fear not! For, behold, I bring you tidings of great joy, which shall be to all people. For unto you is born this day in the city of David a Saviour, which is Christ, the Lord. And this shall be a sign unto you: Ye shall find the babe wrapped in swaddling clothes, lying in a manger.’ And suddenly, there was with the angel a multitude of the Heavenly Host praising God, and saying, ‘Glory to God in the Highest, and on Earth peace, and good will toward men.’” –Luke 2:8-14
I can only imagine what the multitude of Heavenly Host sounded like. May you have a Merry Christmas and find Peace and Joy during every holiday you celebrate, now and throughout the New Year.
Jay Sochoka, R.Ph. isn’t afraid to wish somebody a Merry Christmas.

Phyllis Nish is one of the most gifted musicians with whom I have ever played. Her ability to read piano music is like nothing I have ever seen. She has a terrific touch and the notes just roll out of the piano and organ in St. Eulalia’s Catholic Church where she is the Choir Master. My wife volunteered me (and I was very willing) to play bass in the church Christmas concert at the church on Sunday, December 18, at 7 p.m. Phyllis accepted and dropped off the Isaiah-sized stack of music at work for me. I didn’t rehearse the music but I transcribed the notes for a bass line for all of the songs. My sight reading was pretty good back in the day and these are hymns how fast could they be? Oops.

After four counts Phyllis was off at a runner’s heartbeat tempo, and I was lost after two measures. She had obviously practiced but probably could have had a near flawless first try at it. I picked my jaw up off the floor and realized that I had a lot of practice to do. All of the songs are up tempo and highly nontraditional. She is also going to do me the tremendous favor of recording the songs to a CD and let me write my own bass lines. That is how I learn my songs for The Forgiven Band. This will be an interesting sound, between the pianist who can only read music and the bassist who relies on his ear more than anything else.

I have played previously with the St. Eulailia’s Choir. They know how to sing and, more importantly, how to harmonize. I can’t wait to hear it all put together. I have a lot of homework to do, but that is nothing new. The rule in TFB is to get it rolling at home and then integrate it into a cohesive song at the next rehearsal. I can write some neat stuff to this. If you don’t attend this concert, you are really going to miss something. All who truly want to immerse themselves in the Spirit and true meaning of Christmas are welcome.

This is my kind of concert. They are Christmas carols, not holiday songs, and they are about Jesus, not Santa, presents, and silver bells. Don’t get me wrong—I love almost every Christmas song I hear. I play Pandora’s Christmas Radio station quite often, and they have yet to play a bad song. From December 1-25, I listen to nothing but Christmas songs. I am what you would consider the “anti-Scrooge.” I am the nephew, Fred, who immerses himself in the Christmas spirit every year.

If you are not yet in the Fred stage of Christmas ecstasy, come to St. Eulalia’s on the December 18. It will have you reaching for the eggnog and a piece of gingerbread house.

Jay Sochoka, R.Ph. is probably practicing as you read this.