Part 3 of 7 in the series “What Containers Reveal”
Pharmacy records for patient KOWALSKI, ROBERT J. (DOB: 03/15/1958), retrieved from Harmon Family Pharmacy, Harmon, Illinois. Records span October 2004 to November 2021. Prescriber names abbreviated per pharmacy convention. Pharmacist notes are internal annotations not visible to the patient.
Rx #08-4401 — Filled October 12, 2004 Lisinopril 10mg — 1 tablet daily Qty: 30 / Refills: 11 Prescriber: Dr. A. Menon (Internal Medicine) Pharmacist note: New patient. Transferred from Walgreens. Wife picked up.
Rx #08-4402 — Filled October 12, 2004 Atorvastatin 20mg — 1 tablet daily at bedtime Qty: 30 / Refills: 11 Prescriber: Dr. A. Menon
Rx #08-4401 — Refill #3 — January 14, 2005 Lisinopril 10mg Pharmacist note: Refill 2 weeks late. Patient says he “keeps forgetting.” Counseled on importance of daily compliance.
Rx #09-1187 — Filled March 8, 2005 Metformin 500mg — 1 tablet twice daily with meals Qty: 60 / Refills: 5 Prescriber: Dr. A. Menon Pharmacist note: New diagnosis. Patient asked if this means he has diabetes. Explained Type 2 management. Patient quiet. Wife asked the follow-up questions.
Rx #08-4401 — Refill #7 — July 19, 2005 Lisinopril 10mg Pharmacist note: On time. Compliance improved since March.
Rx #10-0634 — Filled February 2, 2007 Lisinopril 20mg — 1 tablet daily Qty: 30 / Refills: 11 Prescriber: Dr. A. Menon Pharmacist note: Dose increase. Replaces 10mg.
Rx #11-2290 — Filled September 5, 2008 Naproxen 500mg — 1 tablet twice daily as needed Qty: 60 / Refills: 2 Prescriber: Dr. P. Okafor (Orthopedics) Pharmacist note: Right knee. Patient limping when he came in. Asked about his garden — said he can’t kneel anymore.
Rx #11-2290 — Refill #2 — November 3, 2008 Naproxen 500mg Pharmacist note: Early refill (8 days). Within policy. Approved.
Rx #12-0115 — Filled January 20, 2009 Omeprazole 20mg — 1 capsule daily before breakfast Qty: 30 / Refills: 5 Prescriber: Dr. A. Menon Pharmacist note: GI protection — likely NSAID-related. Discussed with patient: the naproxen is hard on his stomach. He said “everything’s hard on something.”
Rx #13-4478 — Filled August 14, 2010 Amlodipine 5mg — 1 tablet daily Qty: 30 / Refills: 11 Prescriber: Dr. A. Menon Pharmacist note: Added to existing BP regimen. Three daily medications now. Set up weekly pill organizer — wife requested it.
Rx #14-0922 — Filled November 30, 2011 Ondansetron 4mg — 1 tablet every 8 hours as needed for nausea Qty: 30 / Refills: 5 Prescriber: Dr. L. Chu (Oncology)
Rx #14-0923 — Filled November 30, 2011 Dexamethasone 4mg — per dosing schedule Qty: 20 / Refills: 0 Prescriber: Dr. L. Chu (Oncology) Pharmacist note: New prescriber. Antiemetic + steroid — chemo adjunct. Checked interaction with metformin (monitor glucose). Patient not present. Wife picked up both. She was wearing her coat but it wasn’t cold.
Rx #14-1104 — Filled December 22, 2011 Ondansetron 8mg — 1 tablet every 8 hours as needed Qty: 30 / Refills: 3 Prescriber: Dr. L. Chu Pharmacist note: Dose doubled. Called Dr. Chu’s office to confirm. Confirmed.
Rx #15-0089 — Filled January 15, 2012 Lorazepam 0.5mg — 1 tablet at bedtime as needed Qty: 15 / Refills: 1 Prescriber: Dr. A. Menon Pharmacist note: Sleep. Discussed dependency risk. Patient said “I just need to sleep.” Did not ask follow-up.
Rx #14-0922 — Refill — February 10, 2012 Ondansetron 8mg Pharmacist note: Wife picked up. Asked about pill-splitting for the 4mg tablets she still has at home. I said that’s fine. She had a list written on the back of a receipt. Very organized. She is always very organized.
Rx #15-0712 — Filled April 3, 2012 Morphine sulfate ER 15mg — 1 tablet every 12 hours Qty: 60 / Refills: 0 Prescriber: Dr. L. Chu (Oncology)
Rx #15-0713 — Filled April 3, 2012 Morphine sulfate IR 15mg — 1 tablet every 4-6 hours as needed for breakthrough pain Qty: 30 / Refills: 1 Prescriber: Dr. L. Chu Pharmacist note: Transition to pain management. Discussed with patient: take the ER on schedule, IR only as needed. He nodded. Wife took notes. I showed her the dosing chart I printed. She folded it into her wallet.
Rx #15-0713 — Refill — April 19, 2012 Morphine sulfate IR 15mg Pharmacist note: 16 days. Within expected range for breakthrough dosing.
Rx #15-0713 — Refill — April 28, 2012 Morphine sulfate IR 15mg Pharmacist note: 9 days. Called Dr. Chu’s office. Authorized.
Rx #15-1180 — Filled May 14, 2012 Morphine sulfate ER 30mg — 1 tablet every 12 hours Qty: 60 / Refills: 0 Prescriber: Dr. L. Chu Pharmacist note: Dose increase. Replaces 15mg ER.
Rx #15-1355 — Filled June 8, 2012 Haloperidol 0.5mg — 1 tablet every 8 hours as needed for agitation Qty: 20 / Refills: 1 Prescriber: Dr. L. Chu
Rx #15-1356 — Filled June 8, 2012 Hyoscyamine 0.125mg — 1 tablet sublingual every 4 hours as needed Qty: 30 / Refills: 1 Prescriber: Dr. L. Chu Pharmacist note: Comfort care. Delivered to home — wife said he can’t come in anymore. House smelled like soup. There were library books on the table by the door, stacked up, overdue.
— No prescriptions filled: Robert J. Kowalski — after June 29, 2012 —
Rx #16-3201 — Filled March 3, 2013 Sertraline 50mg — 1 tablet daily Qty: 30 / Refills: 5 Prescriber: Dr. A. Menon Pharmacist note: Patient: KOWALSKI, DIANE M. (DOB: 06/22/1960). Existing patient — has been picking up Robert’s medications for years. First prescription in her own name at this pharmacy.
Rx #16-3201 — Refill #1 — April 7, 2013 Sertraline 50mg — KOWALSKI, DIANE M. Pharmacist note: 5 days late. Called to remind. She said she’d been meaning to come in.
Rx #16-3201 — Refill #2 — May 1, 2013 Sertraline 50mg — KOWALSKI, DIANE M. Pharmacist note: On time.
Rx #16-3880 — Filled May 1, 2013 Zolpidem 5mg — 1 tablet at bedtime as needed Qty: 15 / Refills: 2 Prescriber: Dr. A. Menon Pharmacist note: Sleep aid. Same prescriber as Robert’s lorazepam. Same reason, probably.
Rx #16-3201 — Refill #3 — June 4, 2013 Sertraline 50mg — KOWALSKI, DIANE M.
Rx #16-3201 — Refill #4 — July 2, 2013 Sertraline 50mg — KOWALSKI, DIANE M. Pharmacist note: She’s coming in regularly now. Looks better. Asked about my daughter’s soccer season — I forgot I’d mentioned it. She remembered.
Rx #17-0445 — Filled September 15, 2013 Sertraline 25mg — 1 tablet daily Qty: 30 / Refills: 3 Prescriber: Dr. A. Menon Pharmacist note: Tapering down. Good sign.
Rx #17-1120 — Filled January 8, 2014 Vitamin D3 2000 IU — 1 capsule daily Qty: 30 / Refills: 11 Prescriber: Dr. A. Menon Pharmacist note: Routine. She asked if we still carry the brand of omeprazole Robert used to take. I said yes. She said okay, she just wanted to know. She didn’t buy any.
Rx #17-1120 — Refill #4 — May 12, 2014 Vitamin D3 2000 IU — KOWALSKI, DIANE M. Pharmacist note: On time. She was with another woman — introduced her as “my friend Carol from the grief group.” They were going to lunch after.
— No prescriptions filled: Diane M. Kowalski — July 2014 through October 2016 —
Rx #22-0887 — Filled November 14, 2016 Lisinopril 10mg — 1 tablet daily Qty: 30 / Refills: 11 Prescriber: Dr. R. Petrov (Internal Medicine) Pharmacist note: Patient: KOWALSKI, DIANE M. New prescriber — Dr. Menon retired in August. I told her Dr. Petrov is good. She said “I’m sure he is” in a way that meant she was not sure. Same medication Robert started on. She noticed too. Neither of us said anything.
Rx #22-0887 — Refill #6 — May 20, 2017 Lisinopril 10mg — KOWALSKI, DIANE M. Pharmacist note: On time. Brought in a photo from a trip — Yellowstone. She went with Carol. She said Robert always wanted to go and she’d never wanted to and now she understands why he wanted to. She bought a magnet for the fridge.
Rx #24-1560 — Filled March 10, 2019 Alendronate 70mg — 1 tablet weekly on empty stomach Qty: 4 / Refills: 11 Prescriber: Dr. R. Petrov Pharmacist note: Osteoporosis prevention. Counseled on administration: take with full glass of water, stay upright 30 minutes. She said “Robert would have hated this one. He never sat still for thirty seconds.” She laughed. First time I’ve heard her laugh about him without it sounding like something else.
Rx #26-0341 — Filled January 6, 2021 Levothyroxine 50mcg — 1 tablet daily on empty stomach Qty: 30 / Refills: 11 Prescriber: Dr. R. Petrov Pharmacist note: Thyroid. Discussed timing — take 30-60 min before food, separate from alendronate days. She said “my mornings are getting complicated” and then said “but at least they’re mine.”
Rx #26-3782 — Filled November 2, 2021 Lisinopril 10mg — KOWALSKI, DIANE M. Levothyroxine 50mcg — KOWALSKI, DIANE M. Vitamin D3 2000 IU — KOWALSKI, DIANE M. Pharmacist note: Sync refill — all three monthly medications aligned. She’s organized. She was always organized. The list on the back of the receipt. The dosing chart folded into her wallet. She keeps things running. She kept him running for as long as he could run and then she kept going. Three prescriptions, once a month, on time. I’ve been filling prescriptions for the Kowalskis for seventeen years. First him, then both of them, then her. The name on the bottles changed but the handwriting on the pickup slips didn’t. She still signs for two.
[Records continue]