image of Dion Herrera, Pharm.D. - Consultant Pharmacist


Health in a "Bottle" - Friday, March 15, 2013

           Intuitively, we all know that we can’t get health from a bottle. In our rushed lifestyles, increasing societal pressures, and stressed-out work lives, we seek out quick fixes for a poor, hurried diet, lack of exercise, and moments of “me” time to center ourselves.

            We consume far too many empty calories for quick energy, take too many fat-burners to lose weight, take too many vitamins and herbal products to substitute for a healthy diet, and pop too many pills to fix the many illnesses – real and perceived which we create in ourselves. And through it all, we spend gobs of money making the companies wealthy in a HOPE that we will be well IF we do all the things they tell us to do from their advertisements.

            Well, there is hope, a REAL hope of health and vitality, and it starts when you decide to put your health FIRST in your life above everything else. I have heard many times that this prioritizing is “impossible”, and that the ___________ (fill in the blank) comes first before your health. So, the question is: If you are not healthy to do whatever other activity/job/responsibility that takes precedence in your life, how long will it be before you are side-lined from doing it due to your poor health?

            I call it, “rolling the dice” – gambling on your longevity, health, stamina, and vitality that you feel is being taken care of by pseudo-healthy methods. Well, here’s a quick tip: It (your health) all adds up, and the benefits are compounded like interest in a deposit account (your body) like in a bank.

If you invest in your health early on, and maintain it into your retirement, you will be someone who takes a minimal amount of medication, and who lives a robust, healthy lifestyle in comparison to your peers at the same age. You will not be part of the group sitting around comparing notes on physicians, medications and health issues in your retirement years.

In my consulting practice, I am seeing both sides of this issue. The clients that took care of themselves well need much less intensive medication reviews than the ones that put everything else, except their health, first. The good news is that it is NEVER too late to start. Even if you have never done one physical thing, eaten properly, or meditated before, the one act of pure intent to start (and re-start) doing it on a daily basis will start transforming your body from the time you begin. I challenge you to give it a try.

Until next time, stay healthy.




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Making Choices - Sunday, March 10, 2013

              Many times patients get tired of taking their medications and stop doing so. Some patients decide to abstain from taking medication altogether, and instead, choose to go the route of alternative therapies to cure their illnesses, while others simply cannot afford to continue taking their medications due to financial hardship.

            For those who are tired of taking their medications, they are demonstrating a lack of faith in their provider and in the provider’s therapeutic plan to control or cure their illness. This therapeutic abandonment is most likely due to a lack of provider-patient communication and therapeutic plan expectations. The patient should not stop their medications, but should meet with their provider to formulate a strategy to achieve the plan’s goals – a plan that is mutually achievable on both sides of it.        

            Patients who shun medications and turn to complimentary alternative therapies to alleviate, cure or control their conditions must be prepared to walk a tough road to health – one that is strewn with disappointment and transient effectiveness the more severe the illness. Also, lifestyle changes with balanced contributions of diet, exercise, rest and mental centeredness is of paramount importance to assist in smoothing the journey to health. Furthermore, taking an “all or nothing” approach is rarely prudent. Illness severity forces common sense to guide the patient intuitively. Trusting progress in the pharmaceutical field to provide the necessary chemicals (drugs) to help the body regain balance and homeostasis is necessary to a balanced approach.

            And for the patients who cannot afford their medications, there are many avenues of assistance available. Affording medications requires financial planning, especially if finances are an issue. Taking an analytical approach to expenses requires the patient to eliminate waste in “wants” and “desires”, while re-directing financial resources to “needs”. Some avenues of assistance are charitable organizations, drug manufacturers and their coupons, and discount pharmacies. Also, asking your provider to stick with generic medications can really help lower your prescription expenses. While each patient’s situation is unique, exploring these avenues can really help you afford your medications.

            Until next week, be healthy.



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The Pharmacist's Real Skills - Tuesday, August 14, 2012

            It amazes me that there are people still thinking that ALL the community pharmacists do is count and sell pills. Briefly, when a prescription is handed in, the pharmacy technician screens the patient and enters the prescription information. A pharmacist then reviews the information for accuracy and then, in conjunction with your other medications, decides its appropriateness. After which, the medication gets billed to the patient's insurance (if they have one), the label prints, the medication is filled by a technician (or pharmacist), and then the finished product is checked by the pharmacist before sale. As you can see, there are many steps along the way to a completed product IF there are no issues with the prescription order.

              One of the most important steps occurs when the pharmacist checks the prescription for accuracy. There are studies which claim that 47-49% of prescription errors occur when the prescription is written. That means that the drug, its dosing, directions or quantity each have the potential to be incorrect, and the pharmacist is trained to catch those errors. Even though e-prescribing has reduced some of these ordering errors, USER error or device programming still creates headaches for physicians when attempting to order medications for patients.

            Another important step is reviewing the medication against the patient's other medications for appropriateness. In the age of multiple providers, both medical and pharmacy, patients are exposing themselves to more harm due to the fragmentation of medication histories and medical information. That means that one provider or pharmacy will not know what another provider or pharmacy is doing in the patient's care because of "shopping around" for best pricing, a second opinion, or specialty treatment.

            While these two steps are taking place in the medication fulfillment process seemingly unnoticed, the public never sees them happening and therefore perceives that the pharmacist is not doing anything noteworthy. What the public sees and portrayed in the media are pharmacists counting out medication, putting it in bottles and labeling them.

          In addition, because pharmacists are so well trained to review medications and catch these errors (with the help of technology), the insurance community is slowly realizing that pharmacists can save them a truckload of money by performing medication therapy management (MTM) services. These services improve patient care, minimize hospitalizations, improve medication adherence and ultimately the patient's health. Unfortunately, the insurance companies want these MTM services for free or for a minimal charge and are resisting pharmacist reimbursement for them. This resistance to reimburse pharmacists for their skills increases the insurance companies' profits, but the patient never sees these savings and continues to pay higher and higher premiums.

         This is just a brief overview of what goes on "behind the scenes" at the pharmacy. I hope I have shed some light on a little of what pharmacists do on a daily basis. If you are interested in learning more about MTM services to help reduce your medication expenses, seek out a nationally certified MTM provider like myself or stop by the APhA website ( Until next time, stay healthy.


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Sticker Shock - Monday, April 30, 2012

Patients are being surprised about prescription prices at the pharmacy counters. Even with insurance, their copayment (the price the insurance tells the pharmacy to charge them) can be in the high double or low triple digit dollars. This financial burden is forcing patients to start asking for alternatives, generics, or even go without their medication - something I do not recommend.  

Furthermore, patients are realizing how much their insurance was subsidizing their prescriptions in the past. Now that the insurance companies are tightening their belts on prescription drug coverage to maintain shareholder value and salaries, they are passing some of the costs to their subscribers in increased premiums and/or copayments. While there are viable alternatives to paying for expensive medications (for example, using generics and manufacturer's coupons), the sad reality is, that for some, there are none. Even some of the alternatives may not suit the patient's condition based on their medical history. So be aware of "off the cuff" recommendations from others especially if they do not have a complete medical/medication history available to them.

On a similar note, patients need to ask themselves, "What can I do to lower my prescription expenses? If there is something that can be done through physical and dietary changes or social activity to minimize a medical condition, then this option should be fully explored to realize monetary savings. In conclusion, I challenge you to take a look at your own medication expenses and seek out competent advice to help you minimize those expenses without sacrificing quality of care...your retirement fund needs the money.

              Until next time, stay healthy.


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On The Horizon - Wednesday, March 28, 2012

                I don’t know if you have noticed, but employers are shifting their focus on how their employees receive healthcare benefits. Most, if not all employees are being asked to be more proactive in monitoring their own healthcare. Preventive measures are being introduced and employers are rewarding those employees who take advantage of those measures with extra money in their HSA accounts or employer-based health funds.

                While these new preventive measures are meant to be proactive in minimizing extensive expenses later on by using early detection and screening, the cost incurred by employees is rising. This shifting expense is another way employers are subtly making employees more responsible. Employers have figured out that heath benefits cost more for the less healthy, while these same benefits cost healthier employees less, and are choosing to reward employees accordingly.

                In the area of pharmacy, employers look at medication costs from a “brand vs. generic” point of view. In a recent study concluded by a major PBM (Pharmacy Benefits Manager), the employer member whose employees opened a dialogue with their physician or pharmacist concerning using less expensive alternatives in treatment, saved more money than those who did not. In addition, that decisiveness was more evident when the employee utilized preventive care.

                These observations are just the beginning. Soon, employers are going to begin charging sicker employees (based on height, weight, blood pressure, blood glucose, etc.) a healthcare premium over those who are healthier, and they will be justified in doing so based on the studies that are currently in progress. The shift will be from rewarding to charging less for those who are healthier. So, what is someone to do? Well, if these studies are an indication, then it will be in the less healthy employee’s best interest to initiate lifestyle changes now to prevent incurring additional charges (taking home less money) when signing up for employer-based healthcare benefits.

                Until next time,


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Pay Yourself First - Tuesday, January 31, 2012

               It should be common knowledge by now that in order to effectively save money, after paying the government their share, you pay yourself next. When I say pay yourself, I mean to set aside some of your money in a savings or investment account BEFORE you spend your earned dollars on bills, needs and wants. This method of saving money will benefit you financially for future years IF you continually put aside some funds every time you get paid.

                You may be asking what does this have to do with your health. While putting aside money every time you get paid will benefit your financial future (by building a nest egg), the same principle applies to your health IF you set aside some activity on a regular basis. What I mean by this is to plan some time in your day to get some exercise in to work out your circulatory (heart), muscular (muscles, joints), skeletal (bones), pulmonary (lungs), and central nervous (brain, mind) systems. By putting a deposit into the exercise “bank” five times weekly, you will build a “health” account of good credit which will benefit you in your later years. When the time comes to “cash in” on all those days of “healthy savings” (exercise days), you will be pleasantly surprised at how well your body will reward you.

                So, no matter if your New Year’s resolutions have fallen by the way already, start paying yourself first and build up that health account. It will be the best investment you ever make.

Until next time, be well.



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New Year - New Habits - Thursday, January 05, 2012

              Happy New year everyone! The New Year brings resolutions - good intentions to change our lives for the better. Like so many resolutions, they usually don’t make it past January, and some linger through mid-March before old habits and behaviors triumph over them.

              This doesn’t mean we should give up on our resolutions, but instead it should fortify our resolve to keep taking action to fulfill those resolutions. Who cares if by mid-March old habits win the day? There is tomorrow to start fresh again – keep trying. If you give in to that chocolate chip cookie and think you “blew your diet”, don’t give up. The very next time you are faced with the temptation, stop and remind yourself why you made that resolution and what goal you want to accomplish. Don’t wait until next week, next month or next year to begin again.

              A quick word on habits – the decision to begin a behavior is a conscious one. The actions to maintain that behavior are conscious ones.  The repetition of those actions over time become subconscious and automatic in nature, and this automatic nature constitutes a habit.  If we are to break this subconscious, automatic action then we must REPLACE the thought of the old decision with a new one.  Once the decision is made, then implementing a new habit follows the same steps as before. It is all mental. Forcing ourselves through “empty” actions – those that we really don’t believe in to change a behavior will probably work in the short-term, but not the long term. We must have a belief in the outcome in order to succeed.

              On that note, I’m going to end this week’s blog by encouraging you to believe in your resolutions, your goals, and your abilities to accomplish them. You have it within yourself to be persistent, consistent, focused and to execute your plan to a better health.  You are worth it.

              Until next time, stay healthy.    


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It's not a lifestyle change, it's a job - Thursday, December 08, 2011

           So often when counseling patients, I bring up non-medication alternatives to assist patients in achieving their health goals. Diet, exercise and social activity changes are generically referred to as lifestyle changes. As a patient, hearing these activities brings up images of putting oneself on a diet, starting an exercise routine, or changing a negative behavior - all of which is or can be a lot of work. Sometimes the work is insurmountable and nothing gets done. For this reason, when I counsel patients, I let them know that changing behaviors is not making lifestyle changes, but more like starting a new job. I find it is easier for them to wrap their minds around this concept instead of something that would require them to change long-standing habits that have led them to a less than desirable health status.

          When viewed as a job, the patient goes through a training phase, a practice phase and an execution phase. While money is not the reward for the hard work and effort that is expended in improving their health, the benefits become apparent in time with a longer, healthier, more active life if they stick to the plan. Just as a job requires you to show up prepared to put effort into your work, making oneself get out of the rut of poor "lifestyle" choices that led to an unhealthy state requires the same mental discipline, decision-making capabilities, focus and attention to achieving a work goal. In addition, being educated in how, when and why the work (of making healthy choices) is important provides a purpose in achieving the desired outcomes (set by the patient).

           This may all seem like a play on words to achieve the desired outcome of a healthier, more active lifestyle; however, how patients perceive the provider's delivered advice to improve (their health) can make or break the strategy in executing the concept of achieving the desired lifestyle. If this perceptive shift helps in bringing about a positive change in just one patient's life, then it is worth it.

           Until next time, stay healthy.


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Put some bacon on it - Sunday, October 23, 2011

    A recently aired commercial from a fast-food restaurant asked, "How do we make our cheesy bowl better?" And the answer was, "We put some bacon on it!" Never mind that the bowl WITHOUT the cheese has 680 total calories, 280 calories from fat, 2180mg of Sodium, 45mg of Cholesterol, 74gm of Carbohydrates and 26 gm of protein per serving, when cheese and bacon are added, the calories increase tremendously. Of course, the commercial has young active men eating the food and enjoying themselves which gives us the impression that if it is ok for them, it is ok for us, too.
    I am sure that if anyone who is the least bit interested in their diet, they would have an overwhelming feeling of nausea come over them at the thought of putting this mix of nutrients into their bodies. This is the stuff that keeps healthcare workers, personal trainers, and the pharmaceutical industry and gym owners employed while putting the diners on the fast track to cardiovascular disease.
    So, how does one eat right? There are two main ways to eat correctly: The older "Plate" and the newer "MyPlate" methods.
        The "Plate" Method
        Favored by Diabetic Educators and Registered Dieticians, the "Plate Method" involves dividing your meal plate into 3 sections:
            1. 1/4 of plate for a lean protein choice,
            2. 1/4 of plate for healthy carbohydrates, and
            3. 1/2 of plate for (low-carbohydrate) vegetables. You can sub out (or add in) to vary carbohydrate intake the following: a cup of fruit, a cup of yogurt and 8oz of low-fat diary drink. For more information, you can search the internet on this topic.
        The "MyPlate" Method
        The new "MyPlate" method was initiated by First Lady Michelle Obama along with the Agriculture Secretary Tom Vilsack earlier this year. This method involves dividing the plate into four sections:
            1. 1/4 of plate for fruits,
            2. 1/4 of plate for grains,
            3. 1/4 of plate for lean protein
            4. 1/4 plate for vegetables, along with a low-fat diary drink.
    From the above methods, you can see their similarities. One thing they both have in common is the apparent lack of a "fat" food group as a choice on the plate. Examples of a "fat" food group choice are cheese, fried "anything", bacon or sausage. Again, for more information on fat food choices, you can search the internet.
    I hope this article clarifies the topic on the proper portions of food groups to eat at each meal. If you choose to follow either of these methods, you can be assured that your diet will improve and your body will reward you with better, longer and healthier performance. Until next time, stay healthy. 



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A Tribute to Steve Jobs - Sunday, October 09, 2011

      I am sure you are probably wondering why a tribute to Steve Jobs is appearing on a medication-related blog. I never met him, but I use his products. As I sit here typing on my MacBook Pro using WordPad in Windows XP to communicate my thoughts, it became quite obvious: Steve Jobs changed how we communicate with each other, how we enjoy our life, and guided the evolution of technology the way he wanted to, based on his creative insights and talents. Steve changed the world, but I'm sure that wasn't his just happened that way.

      Most people really don't care for, or understand the significance of his work or why people would pay tribute to him or his body of work. After all, no one paid tribute to the inventor of chewing gum and that changed the world too. However, what I get from Steve's work here was that we all need to find what we love and, like Nike says, "Just do it". He did, and I am. Communicating medication information to you is my "thing" to do. I don't know if I will change the world doing it, and quite frankly I don't care to. What I do care about is using my knowledge about medications to help others live a better, more-fulfilled life while minimizing drug mis-adventures. This is hardly something to change the world, but every day when I get up, I ask myself one question, "Whose life will I make just a little bit better today"? And, every day I get rewarded by touching at least one in a positive way with my drug knowledge. This does not make me the "Steve Jobs" of pharmacy. Steve Jobs knew how to use his talents, and I am doing the same for others with my drug knowledge.

      And we are not alone. There are others out there too: Oprah Winfrey, Warren Buffet, Bill Gates, the late Elvis Presley, and Michael Jackson, EVERY: artist, educator, healthcare professional, plumber, electrician, athlete, web designer, personal trainer, fry cook, etc. and YOU. You have a talent to help the world be a better place, and if you are not doing it yet, you need to let it out. Don't deny the world your extraordinary talents to help improve it for all of us. In short, the lesson I think Steve Jobs wanted us all to re-learn from his time here was this: "You must fully express your chosen talents and never stop trying to do so". So I ask you, what do you love doing, and why aren't you doing it? And, if you want a "health spin" on this blog, here it is: By doing what you love, your stress will go down, your endorphins will go up, and your immune system will be refreshed - all of which will keep you healthy longer.
      Until next time, stay healthy.

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