If I have to pick a mainstream disease that I despise, it is cancer. Overall, Multiple System Atrophy, which took my Dad, is #1, but that is another column. Cancer has ended too many of my friendships throughout my career. I hate when patients die. I have gone to more viewings this year than weddings, and the number will only grow. Cancer will take a few of them. I just know it.

I don’t think Bill Garrison will mind that I tell you that I am his pharmacist. Bill has liver cancer. That is no secret either, because he will be the guest of honor at a benefit to raise money to for his chemotherapy copayment. Medicare covers a maximum of 80 percent on approved medical procedures. Cancer chemotherapy averages $2,000 per month. That $400 would be two to three weeks’ worth of groceries. I don’t know too many fixed income people who can afford a $400/month hit.

I ask you to support this benefit, which is taking place on Sunday, May 20, at the Springbrook Fire Company Hall. There are at least four bands scheduled to play, starting at 2 p.m. The Forgiven Band, playing one of its many no-charge charity events, will be headlining. May kicks off our summer tour from LA to DC—Lake Ariel to Dickson City. I am also thrilled to announce that we have a deal with Columbia Records. We get 13 albums for a penny and then have to buy 8 at regular price. (You have to be at least 35 to get that second joke.)

TFB has never sounded better. We all have upgraded to top-of-the-line equipment, and we added two new members. We now have the ability to play next to the best Christian bands out there and sound just as good.

Charlie “The Godfather” Bacinelli, after 35+ years as a legendary keyboard player in various bands (most notably XS, which dominated the club circuit from the 80s through the mid-2000s), came to me with an offer I couldn’t refuse. After surviving a highly fatal form of ocular cancer, he wanted me to help form a Christian band with him as the lead guitar player and me on bass. Charlie has become a formidable lead guitarist.

Rounding out the band are Andrea “The Pipes” Picozzo on lead vocals, who sounds like Ann Wilson meeting Robert Plant; “Snotnose Timmy” Tim Depew, on a very versatile (easy by no means) rhythm guitar; and new drummer Gene “Animal” Kashuba on the kit. I would say that this is the most talented lineup we have had. Our sound is brand new, and, as Animal put it, I have some “sexy boom” coming out of my bass amp. The voice and other instruments are even better.

Come out and support the Garrison Family as Bill continues his brave fight. You won’t be disappointed. Peace.

Jay Sochoka, R.Ph., doesn’t have a lot of treasure to tithe. However, time and talent abound.

When the caller ID shows work as the call of origin, a slight panic overtakes me. I instantly wonder if I made a mistake. So far, thank God, that has not been the case. Usually it’s a very quick fix. My wife took the call this time, because I was sneaking in a power nap before band practice. There was no fixing what she was told. A prescription error would have been a blessing.

My partner Michelle called to cushion the blow, so I wouldn’t hear it first thing Monday morning. Bob Hemphill’s house had burned to the ground…and he was in it. “But he got out right?” I asked my wife. He did not. It didn’t even sink in at first. Then it hit me. I lost another friend.

Lieutenant Colonel Robert Hemphill was as nice a guy as you will ever find. If you looked up “Southern Gent” in the dictionary, you would find a picture of “The Colonel” right under the words. That southern drawl, courtesy of a Georgia upbringing, instantly put you at ease in his presence. While you could tell the man was spit-and-polish military from a click away, his demeanor somehow belied that. He was humble, and, with a rank as high as he had in the Army chain of command, that can be hard to come by.

I read his book, Platoon: Bravo Company, and it put me in the jungles of Vietnam right along with him. The Colonel was the commanding officer of director Oliver Stone, who wrote the movie Platoon. Where Mr. Stone’s movie portrayed an Army company of corrupt stoners, The Colonel’s book showed his men and brave and heroic, as well as too busy to be getting into the trouble portrayed in the movie.

The Colonel came out of the Vietnam War a decorated officer. He was awarded the Purple Heart for combat wounds, a Silver Star for gallantry in action, and four bronze stars with V’s for valor in combat. He would have given them all back if it meant that he never lost a man in combat under his command.

Two years ago, he was the guest speaker at the Covington Township Memorial Day service. He told the story of he and his men walking into an ambush. When he got to the part that some of his boys died, he paused. You could hear the anguish in his voice for a few words as he recalled that hellacious memory and how hard he was on himself because men died doing what he told them to do. Forty-two years later, and it was still heavy on his heart.

Maybe he is at peace with it now. I’m sure those men were some of the first people he saw when he went straight up to Heaven. The Army of the Heavenly Host has a new company commander, and they are better for it. Back here, I will miss the Colonel until I see him again. Rest in peace, my friend.

Jay Sochoka, R.Ph., says “Go Army! Beat Navy!”

“It is better to look good, than to feel good,” was the phrase uttered by Billy Crystal in the epic Saturday Night Live skit Fernando’s Hideaway. As far as first impressions go, I would have to agree. When you first meet somebody, without saying a word, you have looked them up and down and have already made a judgement. If they are overweight, you may have already judged them as lazy. If up see someone with wrinkled skin, you automatically tack years onto their age. You may be right about it, but if someone lived in the sun without any protection, you could be off by a decade.

One of the highest compliments I have ever been paid came from my dermatologist, Mark Marsili, M.D.: “You have the skin of a thirty-year-old.” He said that this February. I’ll be 41 in August. I spent years running outside in the sun, and I have skin that looks 10 years younger than I am. That did not happen by accident. I have a comprehensive skin care regimen.

I do not go outside for more than a half hour without putting on sunscreen over the exposed parts of my body. I wash my face with a scrub and facial cleanser. I use eye cream, toner, and moisturizer. I’m usually good for a couple facials a year which, if you never had one—ask for a spa gift card for your birthday. This goes for men too. Live a little.

I sunburn quickly when left out in the summer sun. I tan with SPF 50 sunscreen on. I am rarely out of my shorty wetsuit which is clothing with an SPF equivalent of 50. I apply and reapply sunscreen throughout the day. I bask in the heat of the sun like an iguana but not without armor-like protection from the sun.

I have a friend from Newton Lake whose grandmother we referred to as “The Bronze Goddess.” She spent every afternoon soaking up ultraviolet rays with tanning oil on her skin. Today she looks like a Prada handbag that was left out in the rain and then baked in the sun. Even a Prada, with that kind of treatment, still looks awful.

This goes out to the folks under thirty. You were given very resilient skin that now looks fabulous. That WILL change. Take care of it now, and you will look fabulous for decades. Tan and smoke, and you will look old before your time.

Any pharmacist worth his/her salt will be able to point you in the right direction for good skin care. I know one in Covington Twp. with great skin. He’ll get you on the right track. You only get one epidermis and one shot to keep it pretty. Best to do it right. Peace.

Jay Sochoka, R.Ph. doesn’t own a Prada handbag. He is, however, the author of Fatman in Recovery: Tales from the Brink of Obesity.

Dick Cheney recently received a heart transplant. This proves two things. First, is that evil never dies. Second is that those with excellent health coverage (so good that we paid for it) versus those who don’t, generally live longer and have a higher quality of life. I can’t help but sneer just like Mr. Cheney when I think that his life was saved by government-provided healthcare. I wonder if his view on the public option has changed. Doubtful.

Mr. Cheney had suffered from heart trouble since his 30s. His heart has more bypasses than the Montage Mountain/Davis Street on/off ramps. It’s not like he was just up and picked for a transplant. In all fairness, he was on the transplant list for the past three years. He had to wait just like everybody else, but I can’t help but feel that his ability to pay for the procedure in total and out of pocket, if he had to, moved him up the list past those without the ability to pay. Healthcare has now become a big business with hospital chain corporations saying that they are straight-up “for profit.” The system, as I have said before, is a fractured mess.

One of the best things to come out of 1980′s metal, known as Queensryche, noted in a song that the rich controlled the government, the media, the law. They have moved into healthcare, where those with the means get the best healthcare our country’s highly skilled providers could provide. If Mr. Cheney was an unemployed, uninsured, non-influencing, average citizen with the same health problems, he probably wouldn’t have seen 40, let alone received a heart transplant after being kept alive for the past 35 or so years.

Two “Haves” come to mind when I think of organ transplants. Governor Robert P. Casey (who I admired, even as a New Jersey Republican) received a heart and liver immediately after being elected to a second term. He was on the list a whole 24 hours before an African-American, who happened to be a match, suffered a tragic death.

The second was Mickey Mantle. He received a liver without the doctors checking to see if the cancer had spread. It did. He waited 48 hours for a liver and was dead within a week of the surgery due to the aggressiveness of the cancer. There was talk that his state of health was downplayed so he would get the liver. To this day, the fact that the organ was wasted and could have prolonged the life of a more worthy candidate is still being questioned. For all the good it did him, being famous paid off.

It appears Vice President Cheney is going to be around a while longer, and I wish him well. If it came to light that the heart came from an African-American who always voted Democrat, it would be sauce for the goose. Peace.

Jay Sochoka, R.Ph. is glad to not have heart disease.

In a world that is so progressive on so many issues, open discussions on mental illness still aren’t among them. If you tell somebody you had a heart attack, they’ll talk to you about it. If you tell someone you are bipolar, they just laugh uncomfortably. Tell them you forgot to take your meds, they dial 911. Although the latter is an exaggeration, the former, sometimes, is not. Heart attacks are okay to talk about. Brain attacks? Not so much, and I don’t understand why.

I had a really bad manic episode four years ago, and I’m not afraid to tell people that. In fact, when patients pick up psych meds for the first time in their lives and are wearing shame on their faces, it’s my ice breaker. I want them to know that it is okay, and I know what they are going through. It puts them at ease, and they are instantly more apt to open up to me and feel more relaxed in my presence.

I want people to be able to talk about mental illness, because it helps so much for a person to talk about their troubles. It provides a release. Much like the quadruple bypass patient who opens their shirt to show you their scar, showing your psychological scars helps you deal with the disease.

When I am able to put the journey of my bipolar disorder into perspective, it empowers me to see how far I have come. From the highest manias, I crashed into a depression that was fraught with panic and fear. My self confidence was totally shattered, and my ability to do my job was highly compromised. I was able to do it, but I had so little faith in my abilities, that I worked the day in a full panic, fearing that I would make a mistake. I actually had to leave work a second time to recuperate.

That extra time worked wonders. I came back renewed. I rebuilt my defenses and my coping mechanisms. There was nothing that I couldn’t do behind that counter with nothing less than the full confidence in my ability to do my job.

It upsets me when people give up on themselves too soon; they’d prefer to go on disability rather than undertake the challenging work to get better—and you can get better. People need to learn how to dig down deep, utilize appropriate support systems (family, therapy, proper medication) and pull themselves out of the hole. Otherwise, the stigma attached to mental illnesses will remain. Is it easy to do? No, it’s not. I’m not going to lie to you. Can it be done? Absolutely; I was able to do it and, as I have said in the past, I don’t have super powers.

Mental illness only differs from other conditions with regard to the location of the sickness. Diabetics have a sick pancreas in the same way that I have a sick brain. People with mental illnesses (and those who love them) must step up, take positive measures to get healthy, and set the record straight. Stop hiding it or making people feel ostracized. We need more people to start support groups and more people to attend them. Peace.

Jay Sochoka, R.Ph. thinks it’s time to shine the spotlight on mental illness.

Over the past few days I have run across some horrifying statistics. Eleven percent of a surveyed group of middle school students have admitted to smoking. In high school, the number now is closer to 25. Keep in mind that pretty much everything but the senior class is too young to legally buy a pack. Some of the middle school kids admitted to stealing the cigarettes from older people, such as parents, a sibling, or an older friend. However, it is pretty obvious that “No I.D., No Sale” is not a universal code.

When I was in seventh grade (my first year of middle school) I bought my first pack of cigarettes from Star Drug. I paid $1.92 for a pack of Marlboros. The oddest part about that whole thing was that I had just given a skit in school that afternoon on why you shouldn’t smoke.

That night though my best friend and I were going roller skating. Skateway 9 was a smoker’s paradise. The only place you couldn’t smoke was on the rink. Much to the disappointment of my friends who saw the skit, I wanted to be cool and accepted, so I lit up. Idiotic. Even more idiotic is the fact that I will still bum a cigarette off a person from time to time.

Both of my parents smoked. Even though my parents both told me to never smoke (both had quit by then), and I told them that I wouldn’t, it was…seductive. So seductive in fact that I was about 5 when my Mom left the room with a lit Benson and Hedges in the ashtray, and I took a drag as soon as she left it to answer the phone. Instantly I started coughing and gave myself away. I don’t know who my Mom was madder at, herself or me.

Smoking was always known to be “bad for you,” but it wasn’t until the late 60s or so that it really came to light (no pun intended) how truly disastrous it was. At the least, smoking is going to cost you the ability to breathe efficiently. Emphysema is nothing to laugh at. Neither are arteriosclerosis (hardening of the arteries) and, of course, end-stage lung cancer. Lung cancer is almost always fatal. It they can get 5 years out of you from the day of diagnosis, the oncologists have worked a miracle.

If you are a parent, please show this column to your kid or talk to them about never lighting a cigarette. Teachers, if you have a student that smells like burnt tobacco, have a talk with them. It could be the parents, but it might be the kid. To the stores that sell cigarettes, I.D. everybody that doesn’t look 30 years old—shame on you if you’re willingly selling them to minors. To the kid that smokes, please quit. Smoking is just not worth it. Peace.

Jay Sochoka, R.Ph. wishes he never lit up.

In the past two weeks we talked about America’s addiction to opiates (where prescription medication abuse fatalities sit ahead of automobile related deaths in preventable death statistics) and the dubious, and sometimes shady, practice of treating said addiction with Suboxone. I can kill two gorillas with one bullet on this one. All we have to do is legalize cannabis for medical use. It really is that simple.

Inhaled cannabis provides so many medical benefits. I know patients who took a lot less oxycodone after a surgery because they added cannabis to the drug regimen. I know long term pain management types who are taking lower dose range opiates because of cannabis supplementation. I have seen Adult ADHD patients stabilize without amphetamines and bipolars in a more stable mood range because of cannabis. The herb has a potential that has only begun to be explored.

If I could get a hardcore shooting up heroin addict down to inhaling cannabis, I would call it a win and move on. I would applaud him for making such a smart choice for a drug of choice. The advantages to cannabis over opiates are massive. I’ll focus on two.

First, cannabis is all natural. God made everything on Earth for a reason. I’ll need an explanation for poison ivy and the pickerel, but that’s another story. Cannabis was created to be a medicinal herb and social lubricant. Second, the analgesic effect of cannabis is not fraught with a crippling stupor that high-dose opiates bring. Patients are far more productive and lucid. The side effect profile compared to opiates is very gentle. Mainly, the liver is preserved.

PA House Bill 1393 was drafted and debated but never voted on in the last legislative session. Senate Bill 1003 is on the docket in the upper house as we speak. Hopefully sooner rather than later it will be ratified.

The cannabis is to be distributed through a state-run program, not the shop on every corner California mentality. If this is not put in the pharmacist’s control, it would be nothing short of a crime. If I were CEO of any of the chain pharmacies, I’d have my lobbyists talking the ears off the legislature for the exclusive rights to run the cannabis centers in the state. Some might say it’s a dirty business, but we’re already knee deep in dirty with heroin needles and emergency contraception. The advantages to the patients and the tax revenue generated for the state more than justify the legalization of cannabis for medical use. Peace.

Jay Sochoka, R.Ph. thinks both sides can agree this one.

This country is opiate happy (and pretty much has been since the 1800s.) From Vicodin to heroin,and everything in between, people are swallowing, snorting, and shooting themselves silly with the junk. Doctors are quicker to write for opiates with high doses and a seemingly infinite number of refills. I have been blessed to be at my current post for the past twelve years. I have seen Vicodin habits that long, and I swear that I feel my soul blacken every time I dispense another round to them. As I said last week, no one was practicing medicine this way when I graduated in 1994. I didn’t sign up for this.

From illicit to the perfectly legal, there are narcotic (opiate-based only [amphetamines are not narcotics]) addicts all over the place. Some of them see the havoc wreaked on themselves and those around them, decide that they are drug addicts and want to get clean. There are two ways of doing this. Cold Turkey and through a 12-step recovery program such as Narcotics Anonymous or the Christ-centered Celebrate Recovery (the program I attend), or the far more sinister replacement of a narcotic with a slightly less dangerous narcotic for an indefinite amount time, such as methadone or Suboxone.

What the substitute narcotic does is get the addict high enough to function without being in withdrawal but not high enough to be in oblivion. The original school of thought was to have a patient taper down over a six-month period. I Googled “Suboxone therapy duration” and couldn’t find a finite taper on any page. If need be, Suboxone is a lifetime maintenance medication.

Here is why this is a complete racket. Only a specially-credentialed physician can dispense Suboxone. Some of the more soulless practitioners don’t take insurance for Suboxone patients and grab upwards of $150 for 10 minutes work. Do no harm? HA!

When you see a patient go from here to Lords Valley, Stroudsburg, or Palmerton for a Suboxone script, you know something is up. The “legitimacy” of the Rx is not to be questioned, because everything is legally right on the paper. The ethicality, however, is pure charlatanry.

These “doctors” are simply stringing out patients for a lot of money over time, ad infinitum. They are licensed narcotics peddlers, who somehow manage to sleep at night, convinced that they are saving society. Sadder than this is when you see a heavy narc prescribing doctor get a Suboxone license and keep the patient on the safer hook forever. Whatever board of review granted that licensure really needs to be given a second look. Medical ethics are not what they used to be.

Between pain management and addiction management, we have painted a really rosy picture of medicine. In Star Wars terms, this is the Dark Side of the Force. It is the underbelly of an already rotten city. Next week we will talk about how to change a law and make a lot of this mess go away. Until then, peace.

Jay Sochoka, R.Ph. would like to see more people in 12-step recovery programs.

” I refuse to let it rule me…and I don’t want to become a druggie.”

Those were the words spoken by my beloved wife when I asked her how she deals with the very real, and excruciating, pain of fibromyalgia which she has been bravely battling for 11 years. She basically looks at it as a test by God. It sounds right to me. Saints are made to suffer after all. She gets chiropractic adjustments, a reiki massage here and there, and endures it. That’s it.

Other (certainly not all) patients I have encountered with various pain syndromes are gulping down opiates down by the pail full. I’d like to say that they did this to themselves but I’d by lying. Doctors and pharmacists have a dirty hand in in this, and there is no ignoring it.

When I was a naive new pharmacist, I was out to save the world and to keep junkies from getting the good stuff. I examined every prescription looking for a reason to tell someone to get packing. I questioned the doses from doctors repeatedly hearing the phrase,”New research has shown the dose to be appropriate.”

Apparently, they were right. OxyContin was released in 1996, and the doses were absolutely staggering. Doses of 160 mgs./day were being handed out to everybody with “intractable pain.” Fentanyl patches were being slapped on everyone and there was even some hack from central New Jersey writing for Demerol injection for home administration. Things that were done only in very end stage cancer treatments, due to their toxicity to the liver, were becoming everyday, for-the-rest-of-your-life medication regimens. They didn’t teach us about THAT in pharmacy school. Actually, in 1994 no one was “practicing medicine” that way.

In 2012, things are worse, with the exception that no one is prescribing home injection Demerol anymore. There is more than one Dr. Feelgood in the area, and, if they won’t see you, someone in Stroudsburg will. We have professional narcotic ingesters, whacking down doses of oxycodone and methadone at doses that would kill someone who had never taken them. The prescriptions are “legitimate,” so for a pharmacist to make a call to the doctor and suggest a heart-to-heart with a patient about their problem, it takes a ridiculous drug regimen, a patient forging, or getting early refills. In a society that dispenses insulin syringes (and rightly so) to heroin addicts, we have become immune to addiction.

As I mentioned, we get to sit back and sadly watch patients drastically shorten their life spans and live their lives in a chemically-altered state. I foresee a lot of liver transplants down the road for too many. These people are destroying themselves.

I have even seen heavy-hitting narcotics docs with Suboxone licenses. They can get the gorilla off your back and replace it with a chimpanzee. The level of unethical behavior is simply staggering. We’ll talk about that branch of “medicine” next week. Peace.

Jay Sochoka, R.Ph., wonders what went wrong.

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.