Research leads to laughter!

Anyone who knows me, knows I am not a fan of country music, so, when I needed the title of a country music song to be playing a scene in my book and came across this list...I realized why!

I've highlighted some of my favorites!

The Best Of The Worst Country-western Song Titles
1 - Drop Kick Me, Jesus, Through The Goalposts Of Life
2 - Get Your Biscuits In The Oven And Your Buns In The Bed
3 - Get Your Tongue Outta My Mouth 'Cause I'm Kissing You Goodbye
4 - Her Teeth Were Stained, But Her Heart Was Pure
5 - How Can I Miss You If You Won't Go Away?
6 - How Can You Believe Me When I Say I Love You When You Know I've Been A Liar All My Life?
7 - I Been Roped And Thrown By Jesus In The Holy Ghost Corral
8 - I Changed Her Oil, She Changed My Life
9 - I Don't Know Whether To Kill Myself Or Go Bowling
10 - I Fell In A Pile Of You And Got Love All Over Me
11 - I Flushed You From The Toilets Of My Heart.
12 - I Keep Forgettin' I Forgot About You
13 - I Wanna Whip Your Cow
14 - I Would Have Writ You A Letter, But I Couldn't Spell Yuck!
15 - I Wouldn't Take Her To A Dawg Fight, Cause I'm Afraid She'd Win
16 - I'd Rather Have A Bottle In Front Of Me Than A Frontal Lobotomy
17 - I'm Just A Bug On The Windshield Of Life
18 - I'm The Only Hell Mama Ever Raised
19 - I've Been Flushed From The Bathroom Of Your Heart
20 - I've Got The Hungries For Your Love And I'm Waiting In Your Welfare Line
21 - If I Can't Be Number One In Your Life, Then Number Two On You
22 - If Love Were Oil, I'd Be A Quart Low
23 - If My Nose Were Full Of Nickels, I'd Blow It All On You
24 - If You Don't Leave Me Alone, I'll Go And Find Someone Else Who Will
25 - If You Leave Me, Can I Come Too?
26 - Mama Get The Hammer (There's A Fly On Papa's Head)
27 - My Every Day Silver Is Plastic
28 - My Head Hurts, My Feet Stink, And I Don't Love Jesus
29 - My John Deere Was Breaking Your Field, While Your Dear John Was Breaking My Heart
30 - My Wife Ran Off With My Best Friend, And I Sure Do Miss Him
31 - Oh, I've Got Hair Oil On My Ears And My Glasses Are Slipping Down, But Baby I Can See Through You
32 - Pardon Me, I've Got Someone To Kill
33 - She Got The Gold Mine And I Got The Shaft
34 - She Got The Ring And I Got The Finger
35 - She Made Toothpicks Out Of The Timber Of My Heart
36 - She's Got Freckles On Her, But She's Pretty
37 - Thank God And Greyhound She's Gone
38 - They May Put Me In Prison, But They Can't Stop My Face From Breakin' Out
39 - Velcro Arms, Teflon Heart
40 - When You Leave Walk Out Backwards, So I'll Think You're Walking In
41 - You Can't Have Your Kate And Edith Too
42 - You Can't Roller Skate In A Buffalo Herd
43 - You Done Tore Out My Heart And Stomped That Sucker Flat
44 - You Were Only A Splinter As I Slid Down The Bannister Of Life
45 - You're The Reason Our Baby's So Ugly
46 - I Married Her Just Because She Looks Like You
47 - My Tears Have Washed "I Love You" Off The Blackboard Of My Heart
48 - Don't Cry On My Shoulders 'Cause You're Rustin' My Spurs
49 - I Can't Love Your Body If Your Heart's Not In It
50 - I Wish I Were In Dixie Tonight, But She's Out Of Town
51 - I'll Get Over You As Soon As You Get Out From Under Him
52 - I'm Gonna Hire A Wino To Decorate Our Home
53 - I'm So Miserable Without You It's Like Having You Here
54 - If She Puts Lipstick On My Dipstick I'll Fall In Love
55 - It Takes Me All Night Long To Do What I Used To Do All Night Long
56 - Learning To Live Again Is Killing Me
57 - Please Bypass This Heart
58 - She's Out Doing What I'm Here Doing Without
59 - Do You Love As Good As You Look?
60 - I Keep Forgettin' I Forgot About You
61 - I'm The Only Hell Mama Ever Raised
62 - If You Don't Believe I Love You Just Ask My Wife
63 - Timber, I'm Falling in Love
64 - You're the First Time I Thought About Leaving
65 - Love Will Beat Your Brains Out
66 - Guess My Eyes Were Bigger Than My Heart
67 - It Ain't Love but It Ain't Bad
68 - The Pint of No Return
69 - This Time I'm Gonna Beat You to the Truck
70 - Hell Stays Open All Night
71 - I'd Be Better Off in a Pine Box
72 - I've Got You on My Conscience But At Least You're Off My Back
73 - Bridge Washed Out, I Can't Swim and My Baby's on the Other Side
74 - The Worst You Ever Gave Me Was the Best I Ever Had
75 - She Even Woke Me Up to Say Goodbye
76 - We Used to Just Kiss on the Lips But Now It's All Over
77 - If You Keep Checking Up on Me (I'm Checking Out on You)
78 - It Don't Hurt Half as Bad as Holding You Feels Good
79 - If Fingerprints Showed Up On Skin, Wonder Whose I'd Find On You
80 - She Feels Like A New Man Tonight
81 - The Last Word In Lonesome Is "me"
82 - When We Get Back To the Farm (That's When We Really Go To Town
83 - You Stuck My Heart In a Old Tin Can and Shot It Off a Log
84 - He's Been Drunk Since His Wife's Gone Punk
85.  I Bought the Boots That Just Walked Out On Me
86 - Ever Since I Said "I Do," There's a Lot of Things You Don't
87 - The Next Time You Throw That Fryin' Pan, My Face Ain't Gonna Be There
88 - I Don't Know Whether to Come Home or Go Crazy
89 - If You Can't Feel It (It Ain't There)
90 - Her Body Couldn't Keep You Off My Mind
91 - I Got In At 2 With A 10 And Woke Up At 10 With A 2
92 - I Hate Every Bone In Your Body Except Mine
93 - I Just Bought A Car From The Guy That Stole My Girl, But The Car Don't Run So I Figure We Got An Even Deal
94 - I Knew I'd Hit Rock Bottom When I Woke Up On Top Of You
95 - I Liked You Better Before I Knew You So Well
96 - I Meant Every Word That He Said
97 - I'm Not Married But The Wife Is
98 - If Whiskey Were A Woman I'd Be Married For Sure
99 - Out Of My Head And Back In My Bed
100 - Swing Wide Your Gate Of Love
101 - Tennis Must Be Your Racket 'Cause Love Means Nothin' To You
102 - What Made Milwaukee Famous (Has Made a Loser Out of Me)
103 - Who You Gonna Believe, Me Or Your Lying Eyes?

What's your favorite?

Just so we all can appreciate A LITTLE country - here's one I actually do like!

Israeli Street Fighting...and date night??

Well, in the name of "research",   I persuaded my husband to join me in a krav maga class in Madison. My thanks go out to John Lacy who is a Senior Instructor in Urban Krav Maga and all his students at Black Belt America in Madison, Wisconsin!

My husband and I made it a "date night" and dang...was it fun!

I went to strengthen the writing in my fight scenes and learned more about self-defence than I could have hoped for...

The instructor recommended I read these two books - both are incredible! All women, by the way, should read The Gift of Fear. more new experience checked off and I can tackle the fight
scenes in my novels now and make them that much more

Best Revisng Tip EVER - (you're welcome)

Okay - I HATE revising - writing is the fun part to me. But here's a tip that is saving my ever-lovin' mind.

Step 1: Get a Kindle (if you don't have one, cave...they rock!)
Step 2: Mail your manuscript to your Kindle from Word (they convert the file and deliver it to your Kindle)
Step 3: READ your book on your Kindle. I have spotted MORE errors than I could have thought possible by reading the book, like it's REALLY A BOOK! Plus, you can totally see if paragraphs are way too long, if text/description/dialogue doesn't flow right - and I promise, you'll see errors you've missed in every proofreading attempt previously...

give it a try and let me know if it helps you as much as it's helped!

Have a great weekend - keep writing!

For my new writer friend, Ciara Knight...enjoy :)

Watch this: Best Sam Winchester Scene Ever...

Enjoy Ms. Knight - this is for you - when I should be revising my manuscript!!  (But I couldn't help watching this again a few times, myself...)

Have a great day, everyone...

I just went to a writer's workshop at my lovely local Library in the booming metropolis of Lake Mills, Wisconsin. I was graced by the gift of having two incredible authors break down writing and publishing...

They seem a bit like an odd couple - she is a sexy Romantic Suspense author of Harlequin and he is a Mystery/Horror guy. They jive well and I learned a ton! In case you missed it, here are the top 10 things I learned at the conference...

First - on writing:

1. Start your story in the middle of action - no exceptions, no excuses. Back story should always be worked in later. If you can't make a reader buy your book in three sentences, they won't buy it.

2. When you ask someone for a critique, they should focus on hook, conflict, character, setting/mood, pace/style, resolution, spelling/grammar, and enjoyment.

3. Characters must be unique, have concrete goals, flaws, quirks, great support characters that help AND hinder the main character and there must be an enemy or protagonist.

4. Per Peterson, your goal must be "important, urgent, concrete, and measurable." Make it so...

Second, on publishing...

5. For an ebook to sell, you must write a bloody good book, price it right, format it correctly, and have a great cover.

6. They both endorsed having agents to help guide them in their careers. Even with Konrath being self-pubbed quite it bit, his agent has sold audio rights and foreign rights; agents are still necessary.

7. A web presence is essential--twitter, facebook, blog, website, etc...

8.  There is no right or wrong way to get published--whether by traditional or non-traditional paths--just do what is right for you.

9. If you give away erights your book, check into it first, as it may not be worth it in the long run.

10. The best place to meet contacts at a workshop or conference the bar! (Excellent - advice I will happily heed).

PS - Oh Kindle, my Kindle - I just bought Whiskey Sour and A Cop in her Stocking - can't wait!

J.A. Konrath

What Stephen King taught me about *sigh* Love...

Search for stephen king on writing

My broken foot is pretty well mended and I go back to work tomorrow!  That means less reading and writing and more reality (boo-hoo) - Anywho...I've brought this up in so many conversations recently that I thought I'd share my new found knowledge with everyone!  I read Stephen King's "On Writing" and sincerely loved it (I promise to use adverbs extremeLY rareLY from now on)...but one part in particular is sticking with me...

He is talking about writers and talent and says,
"...I can't lie and say there are no bad writers...Writers form themselves into the pyramid we see in all areas of human talent and human creativity. At the bottom are the bad ones. Above them is a group which is slightly smaller but still large and welcoming; these are the competent writers...The next level is much smaller. These are the really good writers. Above them---above almost all of us---are the Shakespeares, the Faulkners, the Yearses, Shaws, and Eudor Welrys. They are geniuses, divine accidents, gifted in a way which is beyond our ability to understand, let alone attain...While it is impossible to make a competent writer out of a bad writer, and while it is equally impossible to make a great writer out of a good one, it is possible, with lots of hard work, dedication, and timely help, to make a good writer out of a merely competent one." Stephen King

I get what he is saying for writers, but what about relationships? We are over-stimulated by the "genius" love stories - the perfect love from a soul mate that clicks your life's puzzle into place then, dot-dot-dot, happily ever after.

Let's face it - it you ask yourself if you are "in love" with the person you're with and the answer is "no", there is nothing you can do to turn it around no matter how hard you try. But if I extrapolate from Mr. King, with hard work, competent love can be made into good love.

The soul mate perfect love thing is for movies and books. Our real lives consist of a lot of competent love and that's OKAY!!  How can competent love be turned good? Therapy? Date nights? More love-making?

Probably every one is different, but maybe if we diss the ideal as unrealistic and cross-off the bad because we are in love, we can all work harder on turning our competent love into good love

Reading some non-fiction

So, I'm usually a die-hard fiction reader, but I've read a bunch of non-fiction lately which is odd for me. The stand out book was "Publish This Book" by Stephen Markley. I guess if you are going to begin your career with a memoir, this is the way to go and let me tell you why:

1. It starts with haha college humor and a kid trying to find his way after college living in Chicago.
2. He delves into some real life stuff happening to him as he is writing the book and querying agents.
3. The book deepens and makes you fall in love with "his character". I found myself rooting for his relationship, friendships, and getting this book published (even thought I'm holding concrete evidence in my hands of a happy ending).
4. He delves into the WHY of writing and the book moves deeper and deeper inwards the farther into the book you get.

By the end, I'm ready to drive to Chicago to a book signing of his in a bar (my husband said no) and read any fiction he writes from here on out.


Because I feel like I know him and we have a relationship and I'm invested now - forever - in this guy's success.

It you're going to start your career with a memoir - this is the way to do it...

Good Luck Steve!

Too many lines to quote from his book, but here is one...

"We lose millions upon millions of memories every day. We have no way of cataloging all of the things we don't want to forget, but some moments--certain strings of events--manage to stay with us and live in us and occasionally even define us. Everyone has these stories, even if they are unaware of them. They lurk behind our prejudices and our fears. They are the force behind our love and hope, behind the terrible, the wonderful, and even the mediocre. They are the moments that inspire us to write the rest of the story eventually."
Stephen Markley

New Short Story Published

Check out my latest short story published at Every Day Fiction -

Please rate it and/or leave a comment!!

This was a pleasant surprise to wake up to an email with my story - I'm on week three of this stupid broken foot and I'm going a little stir crazy...

Okay - a lot stir crazy -

I honestly miss work and talking to all my patients and coworkers at the pharmacy...

You all have a great day...walking :)

Snap, Crackle, and Pop

Well, here I sit with a broken foot thinking, Wow - now I have a lot of time to blog...

Seeing as this not my first clumsy fall (broke wrist roller skating in 4th grade and broke ankle eight years ago while I was eight months preggers), I've decided to blog about Calcium supplements - pretty pharmaceutical and fitting, no?

Well, here's the latest from Pharmacist's Letter:

Calcium and Vitamin D

Why do I need calcium and vitamin D?

Calcium and vitamin D are important for bone health. Nerves, muscles, and blood vessels need calcium to work. Vitamin D helps the body absorb calcium, and is needed for immune system function. There is some evidence that vitamin D helps prevent cancer and cardiovascular disease.

What are sources of calcium and vitamin D?

Calcium is found in foods. Dairy products are good sources. Eight ounces of yogurt (228 gram) or milk (1 cup [236 mL]), or a 1.5-oz. (43 gram) serving of cheese, can provide around 300 mg. Fortified orange juice can provide 300 mg per 8-oz. (236 mL) serving. Vitamin D is made by sun-exposed skin and is found in some foods. One of the best sources is salmon. A 3-oz. (86 gram) serving of sockeye salmon provides almost 800 IU. A 3-oz. serving of tuna canned in water provides about 150 IU. Dairy products fortified with vitamin D are good sources. Examples include a cup of fortified milk (115 to 124 IU), a cup of fortified orange juice (80 IU), or 6-ounces (171 grams) of fortified yogurt (80 IU). Calcium and vitamin D are also available as supplements.

Do I need a supplement? Are they safe?

Many people are low on vitamin D. It is hard to get enough vitamin D from food, and most people don't get much sun exposure because they use sunscreens, spend long hours indoors, or live at a northern latitude. Most people need a vitamin D supplement. Ask if you should have your vitamin D level checked. People typically get 300 mg calcium from their diet daily, not including dairy. If you include two servings of high-calcium foods (e.g., dairy), you can get around 900 mg per day. Supplementation with just 300 mg of calcium daily, or adding a third high-calcium serving, will provide 1200 mg daily. You may have heard calcium supplements are unsafe. While there has been negative press about heart attacks and prostate cancer, calcium supplements have not been proven to be unsafe. But don't go overboard with calcium supplements; get your calcium from diet when possible. However, avoid calcium supplements from coral or dolomite (a kind of limestone); they can contain heavy metals like lead.

How do I choose a calcium or vitamin D supplement?

Most calcium products contain calcium carbonate (e.g., Tums, Caltrate) or calcium citrate (e.g., Citracal). Both work. Calcium carbonate is cheap and provides the most calcium. Calcium citrate may be better for patients who don't absorb calcium as well, like older people or those on heartburn medications (e.g., omeprazole [Prilosec; Losec (Canada)], ranitidine [Zantac], others). Calcium is best absorbed if no more than 500 mg is taken at a time. Some supplements contain other ingredients (e.g., magnesium, vitamin K), but these don't work any better than those with just calcium. Vitamin D is available over-the-counter in combination with calcium or by itself. There are also high-dose vitamin D products that are prescribed if you have low vitamin D levels. It is okay to take a multivitamin or eat vitamin D-containing foods while taking prescription-strength vitamin D. Vitamin D is available as either vitamin D2 or vitamin D3. Either can be used. Look for a vitamin D supplement that is USP Verified (in Canada, a product with a Natural Product Number [NPN]). These products meet certain quality standards.

How much calcium and vitamin D do I need?

Adults up to 50 years old need 1000 mg of calcium daily. Adults over 50 years old need 1200 mg of calcium daily. Most experts recommend that adults get 800 IU to 2000 IU of vitamin D daily.

[August 2010]

**Reprinted from a Detail-Document from**

Okay - but what about actual Calcium Absorption - the article states that Calcium is best absorbed if 500mg or less is taken at a time. How much Calcium is absorbed from a glass of milk? (My husband is bombarding me with milk and Vivactiv, a yummy chewable Calcium supplement right now)

Well - I don't pretend to have all the answers - but check out this interesting web site:

I don't want to copy it all, but some interesting things are suggested...

Osteoporosis occurs in countries where they drink the most milk...huh?

There are pros and cons to this whole argument...

Here is a rebuttal to milkmyths:

This guy basically says, let's not forget to take into account genetics, latitude and sun exposure, diet, and life style.

I do not purport to have any answers to this. But I see that many of these sites say the same thing: We all need:

1. Physical Exercise
2. To eat fruits and veggies for a balanced diet
3. Injest less caffeine

Even Harvard isn't sold on milk:

I'm going to stick to my dairy, continue to strive for a balanced diet, and chew my Vivactiv - what do you think?

Maybe I should just lay in the sun and find an anti-clutz class - that might work too


Relieve my Stress!

So I recently tweeted about the 5 things I find most relaxing and have received a lot of positive feedback on it. For me,

1. Biking (on a country road alone)
2. Writing (at night with house quiet)
3. Reading (with wine in hand)
4. Swimming (in our glorious pool - today is was NINETY degrees!)
5. Watching a movie in a theater with family or friends (popcorn munching and no pause button for interruptions)

So what do you do to REALLY relax? Let me know...

Then give this a try - Do ALL five of your relaxing things in one day.

I did and it freakin' rocked :)

How to Save Money at the Pharmacy: Our Best Kept Secrets!

Our Top Ten Best-Kept Secrets on how to Save $$ on Your Prescription Drugs:

1. Ask for a generic (pharmacists can by law substitute generic drugs, but it never hurts to ask.)
2. Ask if your medicine comes in a higher strength and can be cut to save costs.
3. Ask for a medicine that is preferred by your insurance as opposed to non-preferred.
4. Ask your pharmacist to review your patient profile and look for cost saving alternatives (we are HERE to do that for you!)
5. If you have an expensive co-pay on a medication that works well for you, look it up online! (Generally, if you look up, the manufacturer will offer coupons or programs to help you save money.)
6. Ask if your pharmacy will match the Walmart $4 generic program. (Most pharmacies will match the Walmart price without you having to switch over your prescriptions to Walmart.)
7. Ask for only a weeks supply of a new medication if you are paying a percentage of the costs. (Once a drug leaves the pharmacy, it cannot usually be returned. So, if you are starting a new med, ask for a reduced quantity to make sure you like how it works for you.)
8. Ask the pharmacist if any of your meds can be combined into one to eliminate one of your co-pays. (Often works best for blood-pressure medicine.)
9. Ask the pharmacist for coupons! (Drug reps often drop off coupons for medicine that we save for people with high prescription costs.)
10. If all else fails, just ASK YOUR PHARMACIST to help. That's what we do :)

Iowa Theatre: Romeo and Juliet opens June 18

Iowa Theatre: Romeo and Juliet opens June 18

Romeo, Romeo, where for art thou, Romeo?

So, I'm going to Iowa (yeah, I said it, IOWA - see link above!) this weekend to watch Romeo and Juliet and I was thinking about falling in love...

Romeo was "in love" with love and pitted against hate. We cheer for love to prevail, even over death. But how often can we fall in love?

When I skid my busy life to a halt and watch tv/movie, read, or see a play, I'm looking to fall in love. I want to read words on a page that speak to my heart and let me inside someone else's rich mind. I want to watch an actor on stage, not to see him portray a character, but fall in love with him by unobtrusively observing them practice their art and letting me see into their soul.

Fall in love by watching someone practice their art whether it be their bedside manner, their command of a room/meeting, the words they use to fill a page, or the details they use to bring a character to life on stage.

How do you let yourself fall in love? Like my beloved Romeo?

"But soft, what light through yonder window breaks?
It is the east and Juliet is the sun!
Arise fair sun and kill the envious moon
Who is already sick and pale with grief
That thou her maid art far more fair than she."

Iowa Theatre: Romeo and Juliet opens June 18

Iowa Theatre: Romeo and Juliet opens June 18

Quill - I love my husband, but...

Well, meet Stogey, my dream, dog. I recently read the book The Five Love Languages to find out why my husband and I are so different. The answer is that I need/give/want verbal praise (ie - you are pretty, etc...) and my husband needs/gives/wants acts of service ("When you cut the lawn, baby, I'm turned on!") which led me to delve into my undying love for my dog Stogey (see cute picture above). My dog (and maybe your pet, too) gives and likes to receive ALL FIVE love languages.

Let me break it down...
1. Verbal praise - "You are a good boy, Stogey!" and he wags his tail. I put on socks and he thinks he might get a walk, so he barks a high pitched bark and runs in circles.

2. Quality time - where I am, the dog will follow. He is always with me, always wants to be near me. When I am up late (like now) he will stand in the kitchen, stare at me and whine while wagging his tail as if to say, "Time for bed, my love."

3. Acts of Service - I take Stogey in the car almost every morning. He jealously barks at other dogs and hangs his head out the window. At twelve, he still loves a long walk. (I'm always embarrassed that when I DO attempt to run, he never pants and looks like he is only walking a little quickly.) He is still on his neverending quest to bring me the gift of a squirrel or one of our pet rats. He brings me toys to throw and never says no whenever I ask him to go anywhere with me.

4. Gifts - If I bring him a new snack or chew toy, he gets crazy excited. (He gets excited even if I launder his current toys and let him get them warm out of the dryer himself.) He gives me the gift of never talking back to me, never being mad at me, and never fighting with me.

5 Physical Touch - petting him makes him close his eyes and moan. We sleep with some part of us connected/touching all night long.

How does this boil down and relate to writing? I guess we are all looking for the perfect man in our romance novels, but are we really just modeling perfection after woman's best friend? I wonder what Stogey and I will say to each other some day in heaven (alas, he is twelve) and it might be nothing, because we both know...we just know.

Tell me about your best friend and what love languages they speak to you.

Time to write about Mr. Right...

(Ps - I DO love my husband!! haha)

Quill AND Pill

The quill part is quick - I just found out my first SHORT story will be published - I'm crazy excited and will post a link to the story as soon as it's available. The title is "Why Not Me?"

The pill portion of the blog related to a wonderful website called Needy Meds:

This is a great website for people who need help paying for their prescriptions - check it out!

The following article is reprinted with permission from Dr. Sagall...

Pharmaceutical Companies Helping Patients Get Their Medicines
By Richard J. Sagall, M.D.

It's a choice no one should have to make - pay rent and buy food or get prescriptions filled. Yet all too often it's a choice Americans, particularly older Americans, have to make.

Over 40 million Americans have no health insurance, and millions more have limited coverage. Many Americans just can't afford healthcare, and, if they can, they don't have the money to buy their medicines.

Patient Assistance Programs
There is help available for many people who can't afford their medicines. These programs, frequently called patient assistance programs (PAPs), are designed to help those in need obtain their medicines at no cost or very low cost.

Many, but not all, pharmaceutical companies have PAPs. The manufacturers who have programs do so for various reasons. Some believe that they have a corporate social obligation to help those who can't afford their products. Others believe it's a good marketing tool. As one PAP director once told me, many people who can't afford their medicines now will go on to obtain some type of coverage. And when they do get this coverage, they will continue using the medication provided by the PAP.

In 2005, PAPs helped over 7 million people. The programs filled over 36 million prescriptions with a total wholesale value of over $5 billion.

The Basics of the Programs
All PAPs are designed to help those in need obtain their medicines. Since each pharmaceutical company establishes its own rules and guidelines, all are different. All have income guidelines, but they vary considerably. Each company selects which drugs are available on their programs and how long a person can receive assistance.

How PAPs Work
Although no two programs are exactly the same, most require that the applicant complete an application form. The amount of information required varies. Some programs require detailed medical and financial information, others very little. All require a doctor's signature. Certain programs require the doctor complete a portion of the form while others only need a signed prescription.

Most send the medicines to the doctor's office for distribution to the patients, while others send the medicine to a pharmacy. A few send a certificate to the patient gives to give the pharmacist.

Some patients need drugs for a long time. Most, but not all, programs that cover medicines used to treat chronic diseases offer refills.

What Medicines are Covered
The pharmaceutical companies decide if they will have a PAP and, if they do, which of their medicines will be available through the program. Some include many or all of the medicines they manufacture while others include only a few. The reasons for these decisions are not something they reveal.

There are a few programs that sell generic medications at a fixed price - currently $18 for a three-month supply and $30 for a six-month supply. These programs are adding more drugs all the time.

Sometimes a medicine or a certain dosage of that medicine will be on a program, then off, and then back on again. Or one dose of the medicine will be on the program but a different dose won't be.

How to Learn about PAPs
Your doctor is not the best source of information on PAPs. Surprisingly, many doctors don't even know PAPs exist. The same applies for pharmacists. Many social workers know about the programs. Books in the library or bookstore on PAPs are probably outdated before they are printed.

The best place to learn about PAPs is the Internet. There are a number of sites that have information on these programs. Many pharmaceutical companies have information on their patient assistant programs on their websites. Unfortunately, it's often hard to find the page that describes their PAP.

Types of Websites
There are two types of websites with information on patient assistance programs. Three sites list information on patient assistance programs - NeedyMeds (, RxAssist (, and ( There is no charge to use the information. These sites don't have a program of their own nor do they help people get their medicines.

NeedyMeds is a non-profit funded by donations, sales of software for managing PAPs, and other sources. The Pharmaceutical Research and Manufacturers of America (PhRMA), an association and lobbying group whose members include many of the larger pharmaceutical manufacturers, runs, which has information on PhRMA members programs.

Then there are a number of sites that charge people to learn about patient assistance programs and complete the application forms. The charges vary, as does the quality of their services. Some offer a money-back guarantee if they can't get your medicines.

How to Use NeedyMeds
Most PAP sites contain similar information. They differ in how they organize the material, the ease in accessing the information, and the timeliness of their data.

To use the NeedyMeds site you begin with the name of your medicine. There are two ways you can check to see if your medicines are available in a patient assistance program. One is to click on the drug list. This brings up an alphabetical list of all the drugs currently on PAPs. Find the medicine you take and clink on its name. This will bring up the program page.

On the program page, you will learn about the specifics of the PAP - the qualification guidelines, the application process, the information you need to supply, what your doctor must complete, etc. In addition, you will learn if there's a downloadable application on the website or if you must get an application from the company. (Some companies accept copies of their application form while others require you complete an original.)

If you know the medicine's manufacturer, you can click on the programs list. From there, you can click on the program you want to learn more about. That should bring up the information you need.

Once you get the information you need, it's up to you to complete the applications, get the necessary signatures, and send the form to the program.

A Few Tips
The most common problem patients encounter when completing the application forms is lack of physician cooperation. Over and over I hear from people whose physicians just won't complete the forms - or charge to do it. I am asked what they should do.

Here are a few suggestions:
1. Make sure you have completed everything on the form that you can. Not only should you complete the applicant's section, but anything else you can fill in. This may include the physician's name and address, phone number, etc.
2. Bring all the information your doctor may need. For example, some programs require proof of income. If so, attach whatever documents are required.
3. Bring an addressed envelope with the appropriate postage.
4. Don't expect your doctor to complete the form immediately. A busy doctor may not have time to read the form while you are in the office.
5. If you encounter resistance, tell your doctor that without his/her help, you won't be able to obtain the medicines he/she is prescribing. Be blunt.
6. If all else fails, you may need to find a physician more sympathetic to your plight and willing to help you.

What if I Don't Have a Computer
Many people without a computer can still use the information available on these websites. Nearly everyone knows someone with a computer - a family member, a neighbor, or a friend. Most public libraries have computers for public use and people who can help those not familiar with their use.

Patient assistance programs may not be the best solution to the problem of inability to pay for medication, but they can help many people. Millions of people use PAPs to get the medicines they need but can¹t afford. If you can't afford your medicines, a patient assistance program may be able to help you.

Richard J. Sagall, M.D., is a board certified family physician. He cofounded NeedyMeds and continues to run the site. He can be reached via the website, He lives in Gloucester, MA.

Copyright ©2010 by NeedyMeds, Inc.
Contents may not be reproduced in any form
except for personal use
and may not be used on any other website without permission


My pool keepeth me from writing. Damn the eighty degree weather that put me in the pool on three separate occations the other day! I should be writing! The ideas that ebb and flow in the mind of a writer are relentless. Ahh, but the pool calls to me. I'll write again when the sun sets...

Or now, while it rains and the house is quiet. As Stephen Markley said one of his teacher's said (or something) "Apply ass to chair."

Pill - How much Tylenol can an adult take?

As a pharmacist, we get asked this question a lot. A quote from


How Much Acetaminophen Is Too Much?
Usually, adults can take one to two 325 mg tablets, every four to six hours as needed. You should not take
more than FOUR GRAMS (4000 mg) of acetaminophen in a 24-hour period. This is equal to about twelve
of the 325 mg tablets, or eight of the extra-strength (500 mg) tablets.
If you have three or more alcoholic drinks a day, ask your healthcare professional whether you should take
acetaminophen or other pain reliever/fever reducers. They will be able to tell you whether or not it’s a good
idea to take acetaminophen, and how much you can safely take.
What About Children?
Children are at special risk of getting too much acetaminophen. The dose for children changes as they grow
older. Check the labels on your child’s medications to see which ones contain acetaminophen. Check with
your pharmacist or other healthcare professional before combining medications and ask what dose is
appropriate for your child. You can also check to see if it’s practical for you to use one acetaminophen
product for all the children in your family. If your children are very different in age, this may not be an
option. In this case be very careful not to confuse which cup, spoon, or dropper goes with which product.
Some products are more concentrated than others, which means you need a smaller amount for a dose.
Lastly, never give young children adult-strength acetaminophen.
[April 2009]


Did you know that the government will soon allow ALL controlled substances to be electronically prescribed? What does that mean - it means that people don't always have to get a hard copy prescription from their doctor/PA/APNP or other prescriber and bring it to the pharmacy. WOW - big news for pharmacists!

Welcome to Quill or Pill!!

Good afternoon all - I just finished planting two flats of flowers - hope they make it in the cold Wisconsin weather! TiVo-ed the season finale of Supernatural - don't tell me what happens!