Canadian Pharmacies

Recently, I found myself in that clichéd American position of needing a medication that I could not afford at American health care prices.  I am usually pretty good at getting around these issues with a well crafted appeal.  But this time, no dice.  I attempted to contact the pharmaceutical company who said I might be able to get it free if I had a proper denial from my health insurance company.  I almost had a proper denial except they wanted me to try a number of drugs just to get the final “No” from them that I was going to get anyway, but that is another story.

The medicine I needed was going to be somewhere between 400 and 600 dollars per shot and I would need 6 shots total.  The spectre of Canadian Pharmacies loomed in the periphery, upon a brief investigation, I found it listed at about 200 per shot.

Easy, right?  Not so fast.  Looking online, I ended up seeing a lot of warnings that stated 97% of “Canadian” pharmacies were scam artists taking advantage of a vulnerable population.  A blog post from Consumer Reports suggests going through NABP approved pharmacies and attempt to look for deals through Costco, Walmart, Walgreens, etc.

NABP or the National Association of the Boards of Pharmacy created a system of verification called VIPPS or Verified Internet Pharmacy Practice Sites.  The concept is useful as the main problem with online pharmacies is verification.  Who am I really sending my money to?  And if only 3% of pharmacies are legit, then the odds aren’t in my favor.

Unfortunately, NABP accredits only 32 online pharmacies with VIPPS certification and all of these pharmacies are brick and mortar American institutions.   (Actually, according to their criteria, their accredited institutions have to be located in the US and registered with the DEA so no Canadian based pharmacy would be accredited anyway)  It is a Möbius strip of verification with all roads leading from and back to American pharma.  Even worse are the accusations that the NABP actively spam legitimate Canadian pharmacies on online forums to create a sense of danger from “rogue” pharmacies, posting up to 1000 times a day.

For due diligence, I check with NABP accredited pharmacies.  I try to look up my medication online and see the prices.  I get ready to break out my spreadsheet to compare and contrast and be a good consumer.  None of these sites are actually set up for a consumer comparison, because in America, there is no set price for these goods.  There is only your price.  The price based on who you are, what insurance you have, and how much they want to charge you.  Maybe if I wanted something more average they could give me an average price.  I even walked into Costco, waited at the prescription drop off counter and talked to the pharmacist who told me, “it’s not in the system, so I can’t tell you how much it would be” essentially putting me in a place of ordering it first and figuring out the price later.

Back to Canada, because it seems to be the only place to actually treat a person like a consumer, not a patient boxed in by the medical industrial complex.  Since the NABP won’t verify a Canadian pharmacy, how do the Canadian pharmacies verify themselves?  The answer to that is CIPA, the Canadian International Pharmacy Association.  To verify a pharmacy through CIPA, you can use their pharmacy verifier, where you enter in the URL of your intended pharmacy.

How does one verify CIPA itself?  The National Bureau of Economic Research (NBER), the largest economics research organization in the United States performed an audit of NABP pharmacies, CIPA pharmacies, and international unverified pharmacies and found that CIPA pharmacies had identical products as NBER pharmacies.  They found the only “rogue” pharmacies to be the third tier, unverified international pharmacies.  The NBER concluded that issuing a blanket warning against all international pharmacies would deny people the savings from certified CIPA pharmacies.  The report from the National Bureau of Economic Research can be purchased here.

The whole process of researching  online pharmacies is marked by obstruction after obstruction.  I spent an afternoon going through website after website trying to answer the question “who do I trust?”  And once I felt like I had an entity to trust, I had to verify why they were trustworthy.  All of this is probably more effort than the average person wants to put in.  The manufacture of fear is a very powerful market force, it makes me wonder how often people pay more for the illusion of safety and security.  And here I sit, prescription in hand and I still haven’t filled it yet.


Meme of the Year 2012

The Guardian has called The Ecce Homo fresco restoration the 2012 meme of the year.  I have to say I have enjoyed the monkey man invasion of art as shown in this tribute gallery.

Personally, I think IKEA monkey could have given it a run for its money.  In true internet parlance, we should ask, “why not both?” as shown in this combo meme picture.

2012:  The year where everything came up Monkey.


Death with Dignity Guest Blog

This guest blog post is currently in submission to the Death with Dignity National Center Blog.

 

Taking on End of Life Decisions as a Family

Both of my parents had careers that brought them close to the larger issues of life and death.  My mother spent her entire career as a nurse, specialising in the treatment of cancer.  My father was a police officer who worked his way up to becoming a detective who investigated homicides.  Through these two careers they both experienced the extreme fragility of life.

My mother in particular would tell me stories of many nights where she held a patient’s hand as the person passed away.  She would half-jokingly refer to herself as a servant on the Rivers Styx, the rivers in Greek mythology that formed the boundary between Earth and the underworld.

There was one incident that left a deep impression on her.  She was working a late night on the cancer ward taking care of woman who was losing her battle.  She had been fighting for months.  Her family was almost constantly at her bedside, urging her to be strong, to pull through.  My mother could see that she was clearly exhausted at the fight.  The patient’s husband left her bedside briefly to take a break and get a cup of coffee.  My mother recalls that practically the second he was out of earshot from the room, his wife chose to die.  She had signed an Advanced Directive which specified that she was not to be resuscitated and these wishes were respected by the nursing staff.  The husband came back to the room and attempted to revive her himself, but in the end, her choice was made.

It was experiences like these that made our family take on the issues of end of life decisions.  We had a family gathering where we all filled out our Advanced Directives together.  Instead of it being a scary conversation that we all had privately, it was a bonding day where we got to understand what each of us wanted.  We spent the day debating what life meant, at what point is there a hope of recovery, and at what point would death be preferred.  None of these decisions were clear cut and it took a lot of soul searching to put answers down.  For anyone else, it might have seemed odd, but for our family, it was an important conversation about to have about life and death.


Dad’s 70th Birthday Surprise Party

About a month ago my Mom walked up to me, talking in a hushed voice saying, “I think I want to throw your father a surprise party.”  From then, a plan was hatched and the game was afoot.  From stealing his cell phone in the middle of the night to get phone numbers of all his friends, to arranging a ruse just elaborate enough to evade suspicion, our house turned into a house full of lies.

We settled on having the party at a neighbor’s house and would run across the street in the middle of the night to deliver plates, napkins, silverware, soda, wine and beer.  Mom squirreled away cash so that he would not see the charges on the credit cards.  We even threw a fake birthday party the day before so he would think that his day had already been celebrated.  I had to suppress a fit of laughter when my mom confessed to forgetting he wanted carrot cake when his fake party had an ice cream instead. (All the while the true cake was hanging out, waiting for the party the next day)

On the day of the party we had fake reservations at a Prime Rib restaurant.  The plan was that Dad was to have an Ipad play date with a friend to figure out how to work his new tablet and then we would all go out to dinner.  In reality, the second he left the house we were supposed to bring the food over and get it warmed up and receive the guests.

It was about this point that all the well laid plans began to fall apart.  I arrived with a car full of food and saw that he hadn’t left to see his friend yet.  I wondered if I should call or not?  Did someone drive him over and it was just his car I saw?  If he didn’t leave, would he see the catering truck arrive?  Finally, in the middle of my panic, he drove off.

Like clockwork, the catering truck with the barbecue main course arrived.  We descended on the house, filling it with side dishes.  I straddled two large stockpots, making two giant batches of collard greens.  My blood pressure spiked as people arrived later than they should and during the time Dad would be coming home.  Fortunately, he was late arriving too so the secret was still safe.

It came down to the last turn of the screw, the ruse.  My neighbor needed to call my house with an emergency, which was that she fell down the stairs and needed help.  My mom took the call with my Dad listening and went through a litany of medical questions.  She rushed over and told my Dad that he needed to come to help lift my neighbor into the car.  There would be no prime rib dinner, no blissful evening with the family, only a trip the ER on his birthday.

We waited quietly for his arrival and shouted “Surprise!” as he walked in.  This was the look on his face when he realized that all of his friends and family had been planning on this for weeks and they had all gathered to wish him a happy 70th Birthday.

Dad being greeted by 30 people shouting “Surprise!” at him.

We even caught his reaction on a friend’s iphone:

And that, my friends, is how you pull off a surprise party.


A joke for the end of the world


365days Project Blog Post

 

A screenshot of my guest blog post.

 

I was asked to do a guest post blog about my experience doing the 365 days project. My 365days daily self portrait project helped inspire to take on his own weekly writing project. Click here to read the guest post.


Pixar goes Burning Man

Someone joked that it looked like the folks at Pixar took some inspiration from the parties at Burning Man for this Toy story short involving the hapless by goodhearted T-Rex toy.  I can definitely see the comparison, but the short is worth watching even you’ve never been to Burning Man.  There is some seriously beautiful animation here:


Partysaurus Rex on Disney Video


What Came First.

Chicken made from egg shells. Created by Kyle Bean


Election Night

 

Voted by Brian J Matis

It is election night and the tension is palpable in the air.  It feels like the final stretch of a long and intractable campaign.  I don’t even want to think about the millions of dollars that have been spent marketing these candidates.  There is the argument that we could have put that money back into our infrastructure and we probably would not have half the problems the candidates debate each other over.  But alas, thus are the stakes in the winner takes all American Democratic process.

It has been an new event to watch my friends declare that they have voted on Facebook.  I guess this is because this is the first time an election has played out so largely on social media in American Politics.  The last presidential election occurred before Facebook was so huge and the midterms didn’t seem half as venomous as this year.  Still, watching the posts saying “I voted” almost feels like social scolding if one hadn’t participated yet.

As for outcomes, I definitely have an opinion of who I want to win. But even more than that, I want it to be a clean win. There are stories about voter disenfranchisement, voters being lied to about when they should vote, voting machines with last minute software patches that can change the tabulating of the vote. These things are a tarnish on the sanctity of democracy. Just let the people vote and let ‘er buck.

And now to go back to being glued to the television watching raptly while NBC fills color into the states on the ice rink in front of Rockefeller Center.


Election Dream

I had a dream a couple of weeks ago that the election was so close that is came down to a bake off where Obama and Romney were competing on their ability to pull off a perfect oembre cake.

Ombre Cake by mellowynk