Happy Valentine's Day!

Testing the limits of Der Blogspot's server - a 6 minute video!

Silent Love, ca 1993, rebuilt and completely not color corrected for the 21st Century!

Gibberish - a KAFI 2005 moment

Created for random insertion throughout the Kalamazoo Animation Festival Internationale in 2005.  Never used.  Probably a good thing....

Created in Flash, rendered into a *.mov format from the Flash *.mov format using Quicktime Pro.

HbA1c sketches

In theory, this shows the cause and effect of blending hemoglobin with glucose - creating glycosylated hemoglobin, and with that the monitoring of HbA1c for diabetes therapy 'adherence' (formerly 'compliance', but that term must have sounded too voluntary to marketers...).

1998 The Animating Apothecary

First Commercial Artwork - 1978-79

For the Michigan Pharmacists Association, ca 1978.  Payment - ten big simoleons for each one!



February 1979 Cover Illustration





December 1978 Cover illustration





Interior article illustration - "Winning with ACES" - February 1979



Bad Pun Department

More fooling around with Photoshop:



(c) 2006 The Animating Apothecary

lulu press link:  http://ar.gy/3UB9

W. C. Fields Forever

From the 1993 Calendar.  Colored in 2013.  Some things just take time, ya know?

(c) 1992 The Animating Apothecary

See the whole first volume! http://www.lulu.com/shop/jim-middleton/uncle-stans-profusely-illustrated-world-no-1/paperback/product-20701680.html

Winning the Lottery - American Style

From a pre-1990 calendar...finally got around to colorizing it.  Lovin' that Photoshop!

(c) 1989 The Animating Apothecary

See the whole first volume! http://www.lulu.com/shop/jim-middleton/uncle-stans-profusely-illustrated-world-no-1/paperback/product-20701680.html

Flawed Animated GIF - version 1, then 2, and finally 3

Yep, those mislabeled layers can be pretty darned pesky.....

Pesky, pesky layers.....

So let's try version 2:

And version 3 (interlaced and smoothed colors via Flash CS4):

...ok...have to remember THAT one!

In spite of popular demand - the 2013 Late Edition Calendar!

Cover of the out of print 2013 edition, in full expensive Technicolor (TM).  OK, not really.  Just in color. 

(c) 2013, The Animating Apothecary

Coming Soon to a Checkout Counter Near YOU!

From the 1994 Calendar:


(c) 1993 The Animating Apothecary



lulu press link:  http://ar.gy/3UB9

Confessions by Pharmacists!

From the 2004 calendar

(c) 2003 The Animating Apothecary

See the whole first volume! http://www.lulu.com/shop/jim-middleton/uncle-stans-profusely-illustrated-world-no-1/paperback/product-20701680.html

Benzodiazepine Use, State of Michigan: 2008 vs 2011

While we wait for the posting of the 2012 data this February, here is a rough estimate of benzodiazepine use in the State of Michigan, comparing 2008 with 2011.
I compiled information on the most popular three - alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin)
The drugs represent total doses of all strengths in their respective category, regardless of dosage form.  Like I said, it's a rough estimate:

Benzodiazepine Use, State of Michigan
2008 vs 2011
(Source: MAPS online data, www.michigan.gov/lara

) 2011 totals 140,980,138      47,443,216      50,635,373
(doses)       alprazolam       lorazepam      clonazepam
per capita
consumption    14                     4                        5

2008 totals 142,127,310      94,886,436      101,270,751
(doses)       alprazolam       lorazepam      clonazepam
per capita
consumption    14                     9                       19

(Based on 2010 census, State of Michigan population: 9,883,635)

NOTE: Unlike data on narcotic/opiate use, this MAPS information is not yet subdivided into specific zip codes.
When that information becomes available (promised soon), I'll be able to break things to some specific cities and villages in Der Mittenstadt!

Old Apple Storage Building in Battle Creek ca 1840s

It stood alongside the site of the old mill race near downtown Battle Creek (the canal has since been filled in).  When constructed, it was on the southernmost part of the town, facing the mill pond and dams built by the city's founder, Sands McCamly.  It was a tour site for schoolchildren through the 1960s, demonstrating that the walls' thickness could store and preserve apples throughout the year without modern refrigeration techniques.
On Memorial Day, 2011, when tornado-force winds tore through the Surreal City, the building's top was blown off.  The rest of the structure was demolished in record time.
I just happened to have shot some video of the building in 2008.  It took me until now to find it!
And so it goes....

Experimental Video Snippets - Posting #100

Using a Panasonic Lumix video function with Sony Vegas and some ancient cylinder recordings....
Hypno Kitty:

And then some Solar Powered Plastique Animaux:

And, finally, some local Winteriness here in Nippishnessville, Michigan (and not a groundhog in sight):

Political Asylum - Work in Progress

Calling it a work in progress is actually optimistic...it's been cluttering space on at least six different PCs since 1999.  If ever completed, it will be a whopping 3 minute opus synchronized to a nice, public domain 1917 recording in my collection.

Part one, created in Autodesk Animator Pro (DOS version!!!) plays with an 1846 photo from the Library of Congress:

Part two, created in Autodesk Animator Pro for Windows 3.11 (beta version), works with multiple layers that had to be sandwiched, optical printer style, in the render that took, as I recall, about 8 minutes...

This third clip is a frame-by-frame reconstruction of some 8mm footage shot in 1973 that may be put to use as well:



An R Crumb Moment, 2000

Inspired while at the 2000 Ottawa Animation Festival.  The two were seated near the program auditorium when I arrived for registration at 8am, and they were still at the same bench when I took an afternoon break at 4. 

Illustration compilation at lulu press.  Here's the link:  http://ar.gy/3UB9

Michigan Board of Pharmacy Check Points - August 2012 (with April 2016 update)

Sample of Board of Pharmacy Inspection Points
(OK, this is a bunch of borrrrring text for those few readers used to lots and lots of cartoons...but sometimes, I need to do things that relate to my "chosen profession").  Please bear with me!

In August of 2012, while performing a pharmacy relief ritual in Michigan, I met a representative of the Pharmacy Board who inspected the site I was at and provided me with the following inspection items upon completion of his review, along with the board’s current interpretation of compliance with them.

April 2016 update: Refrigerator logs
Besides looking at daily signature logs and files of recalled products, the current trend in inspections is to check whether the refrigerator in your pharmacy (for drugs only, of course, NEVER for lunch or food) is within acceptable 1-5 degree C range and that the temperature is checked at least on a daily basis.  That means a simple log affixed to the refrigerator, with the temperature noted and an initial of the noter.  Just a head's up!  Of course, we don't know if the same inspections are done for extended delivery times within wholesaler trucks....but that's for another blog discussion!

Is the generic drug supplier noted on the label/receipt?
This is a no-brainer, provided your software is up to grade. Labels should be providing this automatically. I fill in at pharmacies that use SRS nearly exclusively, and they do a great job of keeping the labels filled with the most elaborate minutiae required by pharmacy boards and insurance companies. However, it should be noted that inpatient hospital pharmacies often make use of software that does not provide this information on the labels, labels generally created to fill discharge or employee prescriptions, a function that hospital software vendors may regard as ancillary at best–this may be a setting for procedural violations by the Michigan board.

Does the pharmacist hand initial all new prescriptions?
The initial needs to be on the back of new prescriptions, preferably on or across the software-generated label, with the date of the initial fill or profiling. Also, in the case of filling a prescription that has been previously profiled, the new software-generated prescription label needs to be affixed to the back of the prescription to indicate the date of filling.

Does the pharmacy have all necessary equipment and supplies/references?
The inspector wanted to know about the most current drug information available - specifically, which on-line service for this information does the pharmacy use. This particular pharmacy made use of Facts and Comparisons online, so that was covered. If printed references are used, they should be of the sort that are updated monthly, and the updates should be in place.

Does the pharmacy meet the minimum housing requirements?
This was an eyeball inspection. In essence, are there at least 200 square feet, is the roof secure, and are the rats kept outside.

Are the drugs obtained from legitimate sources, also quality and purity? Expired meds?
If your pharmacy is in the habit of placing ‘return to stock’ meds (ie, those not picked up after two weeks) on the shelf in the original vials, understand that the board interprets the ‘use by’ date on the label to be the expiration for that particular drug. Also, if the pharmacy pre-packs routinely used quantities - ie, Sertraline 100mg, 30ct - the vials need to have the company name, the lot number, and the expiration date. Theoretically, the inspector could also ask to see your repackaging log for these activities. The inspector also uses this item to ask about any files you have regarding drug recalls and whether the pharmacy has had any drugs returned due to recall, and if so, the documentation of that return.

Is the pharmacist using professional judgment when filling prescriptions?
This is geared for pharmacies near physicians who may have become rather casual about the quantities of controlled substances they order. If a physician is ordering 500 Methadone 10mg for a single patient monthly, and is doing that sort of thing for many patients, and the physician is not a world-recognized pain control expert, the inspector may consider routinely, unquestioningly filling such prescriptions to be an example of NOT using professional judgement.

Is the pharmacist counseling first time prescriptions?
Again, this is an eyeball view by the inspector during the visit. Insurance companies (Blue Cross, et al) like to throw this into some of their audits as well, I have noted, and I like to ask such auditors for some identification from the Michigan Board of Pharmacy.

Are there Policy and Procedures for designated tasks? Are they updated?
This is something that was interesting from an independent retail perspective. First of all, you need the policies about specific technician ‘can’ and ‘cannot’ do duties. Then you have to document that the technicians have read and understood these policies. Then you have to document that you have periodically reviewed these policies. Suddenly things felt like a JCAHO survey...

Are CII drugs locked or dispersed?
Well, yes they are.


Are CII invoices in a separate file?
The inspector wants to see the wholesaler files to verify that the controlled substances and the CIIs are all nice and separated.

Are controlled substances invoices dated and initialed?
And by that, they mean, by the pharmacist.

Do all controlled prescriptions indicate the quantity both written and numeric?
These are prescriptions from the physician, not phone orders. If a prescription falls into the pharmacy’s sphere with only the numeric quantity on it, the pharmacy had best be sure to fill in the written quantity, and then document that a call has been made to the physician to verify it.

Do all controlled prescriptions have a hand written signature?
This is still that gray area while e-prescribing and electronic signatures are becoming increasingly mandated at a federal level, but the states are still playing catch up with the technology. The prescriptions must have a hand written signature. If it looks like an electronic ‘stamped’ signature, it should be noted as having been verified by phone, and from whom the verification was obtained.
One further note - if the controlled substance is written by a PA or NP, the prescription MUST have BOTH the names and DEAs of the PA or NP *AND* the name and DEA of the 'overseeing physician.'
So the signature should look like:
Alexis H. Ceasar, NP DEA MC3232321, Dr. Dandy DO, DEA AD1234596
I am waiting word on how this is to play out with extended prescribing authority in Michigan for NPs who will be running their own, independent clinics.

Do faxed prescriptions display all required information - especially the name of receiving pharmacy
This is to protect from multiple pharmacies getting the same faxed prescription. If the pharmacy gets a cover letter to the faxed prescription, ATTACH IT to the prescription.

Do telephone prescriptions identify the sender/receiving individual?
On controlled substances especially, the signature on phoned prescriptions should read something like this: "Dr. Bonzo/Elaine RN/RPh initial." And that pharmacist initial had better be on the FRONT of the prescription - the initial on the back is only to acknowledge the first fill of the prescription.

Is the pharmacy reporting to MAPS
If the pharmacy isn’t doing this, it is presumed that the pharmacy is trying to hide some of its controlled substance dispensing activities. As the software becomes more sophisticated, more and more of the data is being used for tracking purposes of MANY activities. Google "Bob" Patel, Pharmacist, in Michigan to see the results of some of this tracking (and see this link of 1 Feb 2103 for final disposition of the results of the investigation: http://www.mlive.com/news/detroit/index.ssf/2013/02/owner_of_26_detroit-area_pharm.html )
See end of this post for the pharmacies involved...
Is there compliance with the Code of Federal Regulations?
Not sure how the inspector determined this one, but the pharmacy got a pass on it.

Is the pharmacy filing its annual inventory?
This is especially for the controlled substances. Again, this data will eventually get tied to MAPS data to check for variances.

Is the professional license/limitations displayed?
And by displayed, that means so the unwashed, huddled masses at the cash register can see it.

Is the Consumer Information Notice (CIN) displayed?
Ditto above.

Are prescription drugs branded correctly?
That means, can the inspector go to a bag in the pickup bins, open it up, open the vial, and see that the drug brand in the bottle is the drug brand on the label and on the shelf. I guess this is to prevent someone from using any old generic fluoxetine for Serafem.

Well, that’s the world of pharmacy inspections in Michigan as of August 2012. Some of these items seem a bit odd in the 21^st century - so many fussy fiddlings with little scraps of paper that are more reminiscent of the 1970s than in the age of the internet...but as I have said, if the Board of Pharmacy stipulates pharmacists wear paisley boxers, it’s time to visit the underwear counter at Sears!

The Patel pharmacies involved in the original indictment were (from : http://www.crainsdetroit.com/article/20110802/FREE/110809971/canton-pharmacy-owner-25-others-accused-of-billing-fraud-involving-painkillers )

Detroit:• Caring Pharmacy, 4000 W. Davison
• Detroit Care Pharmacy and the Responsible Care Pharmacy, both at a similar address on Mack Avenue
• Four pharmacy store or business names all listed at 19460 Grand River Ave.: Grand River Pharmacy, Friendly Pharmacy, Levan Pharmacy and Kalika Corp.
• Prestige Pharmacy on Dexter Road
• Glendale Pharmacy on Glendale
• Care For You Pharmacy on West McNichols Road

Warren:
• Best Care Pharmacy, 27101 Schoenherr Road
• Highland Park Pharmacy, 28001 Schoenherr Road
• Rapid Pharmacy, 11664 Martin Road

Bay City:
• Sapphire Apothecary on South Trumbell
• Tri-City Apothecary on Katalin Court
Other locations:
• Rapid Drugs, later Noble Care Pharmacy, in Southfield
• Independent Community Pharmacy, Dearborn
• Taylor Apothecary, Taylor
• Be Well Pharmacy, Berkley
• Airport Apothecary, with addresses in Waterford Township and Bloomfield Hills
• Rx Now Pharmacy, Livonia
• Commerce Township Pharmacy, Union Lake, Commerce Township
• Eastpointe Pharmacy, Roseville
• Preferred Care Pharmacy, Pontiac
• Preferred Pharmacy, Troy
• Prestige Drugs, Hazel Park
• Prestige Drugs Pharmacy, Oak Park
• Davenport Pharmacy, Saginaw
• Diamond Pharmacy, Kalamazoo

--And add to that, "Tri-Star" Pharmacy in Battle Creek

Happy Holidays from the Animating Apothecary!



(c) 1997 The Animating Apothecary

 See the whole first volume! http://www.lulu.com/shop/jim-middleton/uncle-stans-profusely-illustrated-world-no-1/paperback/product-20701680.html

Herbal Pharmacy



(c) 1993 The Animating Apothecary



Nutritional Pharmacy

(c) 1991 The Animating Apothecary

See the whole first volume! http://www.lulu.com/shop/jim-middleton/uncle-stans-profusely-illustrated-world-no-1/paperback/product-20701680.html