Venting about MDs vs. Pharmacists

[meister]

I wanna try and experiment to see if they just go along with what we recommend or if they are actually thinking.

For example, let's say there is a script for Avelox 400 mg daily for 10 days being used for CAP and it is not covered by insurance. I wonder if I call and make a recommendation to switch to a completely different class that doesn't even treat the damned bug, would they just go along.

I have actually had this happen at least twice. "Patient's insurance doesn't pay for Avelox, the pharmacist wants to know if you want to switch to Cipro?"

I just assume they didn't bother asking the patient what the diagnosis was or something.

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[owlegrad]

I have actually had this happen at least twice. "Patient's insurance doesn't pay for Avelox, the pharmacist wants to know if you want to switch to Cipro?"

I just assume they didn't bother asking the patient what the diagnosis was or something.

I hate to generalize, but that is a recipe for disaster.

 

[rxlea]

I wish docs would write the dx on some of those scripts

 

[DrMom]

I wish docs would write the dx on some of those scripts

I used to do that somewhat regularly when I would handwrite Rxs, but with the hospital's computerized Rx system it isn't quite so simple.

 

[rxlea]

I used to do that somewhat regularly when I would handwrite Rxs, but with the hospital's computerized Rx system it isn't quite so simple.

That's unfortunate. They should add in a field where you can just type it out: "UTI", "URI" ya know? Oh well.

 

[DrMom]

I agree, but that's one of many problems with the system. I can't do prednisone tapers, pediatric zithromax, and I can't truly customize the # of pills I want dispensed (ie: narcotic Rxs).

I think putting the reason for the Rx is helpful for you guys and the patients.

 

[spacecowgirl]

I agree, but that's one of many problems with the system. I can't do prednisone tapers, pediatric zithromax, and I can't truly customize the # of pills I want dispensed (ie: narcotic Rxs).

I think putting the reason for the Rx is helpful for you guys and the patients.

That's weird. What system do you use? Our system has entries for all sort of weight-based drugs, tapers, unusual dosing.

 

[pfaction]

My attitudes are much more cynical, and I believe, more grounded in reality.

When you accept the fact that the majority of us can be replaced by Lexi-Comp, Micromedex, etc, this topic will really hit into gear. Doctors: Can I put drug into this solution? You: Let me check. Doctor: Is a 50 mg Toprol BID dosing acceptable in the patient with this drug? You: Let me check. Doctor: What do you recommend for... you: let me check.

We are nothing but actual drug info and a liability. Did the technician put 100 mg Hydralazine tabs or hydroxyzine tabs in the package? HIT ENTER ON SCREEN TO MAKE SURE IMAGE MATCHES TAB. I view it as such. Our signature is a liability.

Those who pursue clinical pharmacy enter actual medicinal practice, and should be distinguished. Certainly there are similarities, though.

Always remember: "OTC Recommendations" are nothing but verbal prescriptions - entering a doctor/intermediary's scope of practice. Administering flu shots is absolutely no different. There have been talks about CDTM. Are we no longer a profession, but a blob with our arms in other things? I don't even know what a pharmacist does anymore. Dispensing, then counseling, then administering flu shots, now prescribing?

We are doing nothing new but leeching from other HCPs, all while continuing to be solely drug info and signature liabilities.

But pfaction, what if the MD overdoses? What if the BSA isn't correct? Math isn't right, can kill patient! Therapy wasn't right choice!

This is why you are a textbook and liability. Otherwise, that's it. It's up to the nurses.

You don't deserve $100,000. If I shot you in the head and replaced you with a textbook, chances are there would be no detriment.

This is a recently graduated pharmacist as I view it. This is what I am aiming not to be when I go on rotations, and what I WON'T be when I graduate. We can go to n# of brown bags where we look everything up on micromedex on our iPhones but let's never kid ourselves about our profession.

 

[Thoughtfulsinner]

My attitudes are much more cynical, and I believe, more grounded in reality.

When you accept the fact that the majority of us can be replaced by Lexi-Comp, Micromedex, etc, this topic will really hit into gear. Doctors: Can I put drug into this solution? You: Let me check. Doctor: Is a 50 mg Toprol BID dosing acceptable in the patient with this drug? You: Let me check. Doctor: What do you recommend for... you: let me check.

We are nothing but actual drug info and a liability. Did the technician put 100 mg Hydralazine tabs or hydroxyzine tabs in the package? HIT ENTER ON SCREEN TO MAKE SURE IMAGE MATCHES TAB. I view it as such. Our signature is a liability.

Those who pursue clinical pharmacy enter actual medicinal practice, and should be distinguished. Certainly there are similarities, though.

Always remember: "OTC Recommendations" are nothing but verbal prescriptions - entering a doctor/intermediary's scope of practice. Administering flu shots is absolutely no different. There have been talks about CDTM. Are we no longer a profession, but a blob with our arms in other things? I don't even know what a pharmacist does anymore. Dispensing, then counseling, then administering flu shots, now prescribing?

We are doing nothing new but leeching from other HCPs, all while continuing to be solely drug info and signature liabilities.

But pfaction, what if the MD overdoses? What if the BSA isn't correct? Math isn't right, can kill patient! Therapy wasn't right choice!

This is why you are a textbook and liability. Otherwise, that's it. It's up to the nurses.

You don't deserve $100,000. If I shot you in the head and replaced you with a textbook, chances are there would be no detriment.

This is a recently graduated pharmacist as I view it. This is what I am aiming not to be when I go on rotations, and what I WON'T be when I graduate. We can go to n# of brown bags where we look everything up on micromedex on our iPhones but let's never kid ourselves about our profession.

I agree with this post which is part of the reason I'm going back to get an M.D.

And a lot of pharmacists make much more than 100K. It is truly ridiculous.

 

[owlegrad]

This is a recently graduated pharmacist as I view it. This is what I am aiming not to be when I go on rotations, and what I WON'T be when I graduate. We can go to n# of brown bags where we look everything up on micromedex on our iPhones but let's never kid ourselves about our profession.

You only list what you are aiming not to be, may I ask what you plan to be?

 

[pfaction]

Have you been accepted into a med school? I'm trying to do similar.

Previous page had an interesting thing about doxy tabs vs caps. I wanted to smash my face through the computer screen. Pharmacy is now about asking tabs vs caps. Yeah, for tizandine it may be PK different. Guess what? Probably gonna end up with the same effect.

Now, hydroxyzine pamoate and HCL was a good example where my thing isn't valid. So maybe there's some nice 100,000k for being able to ask which salt of the drug to give, since they're different indications. I will concede here. How many drugs are like that? Maybe metoprolol, which again could be two ways? Perhaps another concession.

 

[Thoughtfulsinner]

Don't forget about calling to switch triamterene/hctz capsules to tablets. That's why pharmacists earn the big bucks!

 

[pfaction]

You only list what you are aiming not to be, may I ask what you plan to be?

I HOPE to offer more than just textbook answers of dosing and pharmacologic classes and more guideline stuff. Unfortunately, I doubt this will happen. Something that has happened in my 3rd year: patient was on vanco, BUN of 114, SCr high, doctor continued drug. I asked if we should consider renal function, so clinical pharmacist and doctor worked out dosing. Ideally, I would love to see a HIT like situation where I can say it is a drug induced disease [A DIAGNOSIS?] and then offer up a solution (D/C, DTI like argatro if renal or bival if hepatic) or something. I'm just entering my fifth year, so we're still in therapeutics mode. In fact, I have a kinetics test Monday.

I'm obviously naive and envisioning too much for the pharmacy career and my own rotations. Based on my IPPEs and what my friends have told me, it'll be the same. Rounding, doctor and residents will diagnose. They will prescribe. You will look at medications, see 1) any C/I. 2) guideline based. 3) dose appropriate? 4) any new monitors.

Plug and chug. I see no way I will be different. But I hope that when I round with the students, I will be able to contribute pathophysio before I go into textbook drug mode.

---

And another criticism - people say we're being also paid for MTM, where we ask patients if they're using their drugs correctly, correct dosing, etc.

So we thwart OBRA90 counseling by attaching a piece of paper to their bags. Read paper, any questions, it's on the paper! Yep, how to use it is inside, should be straight forward.

And now we're aiming to get more money...to explain the things...on the paper...that we were supposed to tell them...in the first place?

We're getting paid (extra?) because people can't read? Maybe they should hire at-home nurses?

 

[owlegrad]

I wish you the best of luck. Hopefully you can inspire more people to want to do more for their patients.

 

[pfaction]

I wish you the best of luck. Hopefully you can inspire more people to want to do more for their patients.

Thanks. I sincerely doubt it. With the job market people are doing more and more, and I'm not the only one that feels this way. They claim to want to do it for the patient, but they're the first to break out their cellphones or not review their drugs before going on rotations. You want to make a good impression? Know some stuff off the top of your head. And that's what I'm doing during my off times, constantly reviewing.

I have pushed myself academically, scientifically and hopefully will do so clinically when on rotations.

But as I said before, I am naive and too ambitious. None of this will happen. It is very well a pyramid, where even on rotations we are looked to as the "fact checker". I doubt anything I do will break myself out of the mold--especially since we learn as much pathophysiology as medical students learn about pharmacology.

 

[owlegrad]

But as I said before, I am naive and too ambitious. None of this will happen. It is very well a pyramid, where even on rotations we are looked to as the "fact checker". I doubt anything I do will break myself out of the mold--especially since we learn as much pathophysiology as medical students learn about pharmacology.

I know, it's almost as though we are separate fields with different focuses or something. Weird.

 

[pfaction]

I guess you're right, continue using ethosuximide for grand mal seizures. Maybe high dose ibuprofen for the patient's osteoarthritis. Or is our focus on the side effects of the drug, rather than a correct pathophysiological indication?

 

[owlegrad]

I guess you're right, continue using ethosuximide for grand mal seizures. Maybe high dose ibuprofen for the patient's osteoarthritis. Or is our focus on the side effects of the drug, rather than a correct pathophysiological indication?

Don't mind me, I try to fight it, but sometimes my sarcasm just busts out even when I try to hold it in. Not sure I can explain it from a pathophysiology perspective though - I am not a med student after all.

 

[pfaction]

Absence seizures are not the same as grand mal. Ethosuximide is solely for absence. Calcium channel inhibitor, T-type or something, I forget. See? I need to review. But if that MD prescribed it, the pathophysiology would be incorrect, and I could point that out on rounds. That is perhaps the pharmacology of the drug so once again I am putting myself in a box.
OA is APAP, at least what we were taught. NSAIDs are avoided or topical, some people say low dose 2nd line.

Replace sarcasm with frustration in your sentence. That is me.

What year are you in?

---

Beta-blocker pharmacogenetics
may help to explain the
clinical observation that Caucasians
are more likely to have a better blood
pressure response to a b-blocker
than do African Americans, since
the frequency of the Arg389 allele
in ADRB1 is higher in Caucasians
(73%) than in African Americans
(58%) and carrying the Arg389 allele
predicts a greater blood pressure reduction
after b-blocker treatment.55

I think we all know the AB/CD of anti hypertensives.

This blew my f'n mind. Pathophysiology (pharmacogenetics/genomics, which I am really interested in), at work. This is why they respond less to A/B.

 

[group_theory]

Absence seizures are not the same as grand mal. Ethosuximide is solely for absence. Calcium channel inhibitor, T-type or something, I forget. See? I need to review. But if that MD prescribed it, the pathophysiology would be incorrect, and I could point that out on rounds. That is perhaps the pharmacology of the drug so once again I am putting myself in a box.
OA is APAP, at least what we were taught. NSAIDs are avoided or topical, some people say low dose 2nd line.

Replace sarcasm with frustration in your sentence. That is me.

If a patient is on Zarontin for absence seizures, most likely it was prescribed by a pediatric neurologist. You can point that out on rounds, but in most cases, the docs will defer to the neurologist. You will be hard press to find a PCP or even a hospitalist who will start something like Zarontin without consulting with a neurologist first.

Now if you speak up about starting Zarontin on someone already on Depakote and Dilantin, then I'm all ears

For OA - depends on severity and site. Tylenol works ok but people with moderate to severe OA don't get enough relief to do their activities of daily living. Some find additional relief with NSAIDS (which is why the selective COX2 inhibitors were so popular - because they worked). If it is a large joint, sometimes synvist or intra-articular steroid injections can provide significant relief.

 

[pfaction]

It speaks to my naivete that you are so easily able to correct me. Thank you for that, by the way. Another thing I will always be is humble. I always accept that I am wrong but will defend my answer with lit if I think I am right.

We also learned that COX2 wasn't that great in OA unless patient was psychologically hooked to it (meaning they wanted the drug...not addiction, but you know what I mean), incr. CV risks, and you're definitely right on the last part. IA steroids right after that. Then again, we were told not to use NSAIDS in OA because there's no real inflammation.

 

[group_theory]

Ideally, I would love to see a HIT like situation where I can say it is a drug induced disease [A DIAGNOSIS?] and then offer up a solution (D/C, DTI like argatro if renal or bival if hepatic) or something. I'm just entering my fifth year, so we're still in therapeutics mode. In fact, I have a kinetics test Monday.

What if the patient is on procainamide or INH?
What if your patient has renal failure, fever, confused, and anemic?
What if your patient has sickle cell and LUQ pain?
What if your patient has a large liver, enlarge lymph nodes and malaise?
What if your patient is pregnant, and also have abnormal LFTs?
What if your patient has diarrhea, icteric buccal mucosa, anemia, and renal failure?

*post mainly to generate discussion on acute thrombocytopenia, and the danger of making a diagnosis without the whole picture (or having a good differential diagnosis)

 

[pfaction]

1) DISLE?
2) Is the pregnant one HELLP?

Otherwise I don't know the rest.

 

[WVUPharm2007]

Dammit all to hell. I thought this abortion of a thread was gone and buried, but it had to get all Jesus on me and come back to life.

Easter was like 2 or 3 months ago...get with the program...

 

[Socrates25]

However, your exaggerations to the point of hyperbole are ridiculous. A GP and pharmacist (many of whom have BLS and/or ACLS training) would likely handle a trauma patient in the same manner - by calling 911 and waiting with the victim.

I dont agree. While its true that if a GP and pharmacist were both in the middle of nowhere with no equipment they would probably do the same thing, but if a trauma happened right outside a GP's office he can intubate the patient and start IVs while waiting for paramedics to arrive which is something the pharmacist couldnt do. Not saying its a likely occurrence, but there is clearly a difference in the level/support of care offered.

 

[Sparda29]

Stop posting in this thread, mods lock it up.

 

[njac]

I dont agree. While its true that if a GP and pharmacist were both in the middle of nowhere with no equipment they would probably do the same thing, but if a trauma happened right outside a GP's office he can intubate the patient and start IVs while waiting for paramedics to arrive which is something the pharmacist couldnt do. Not saying its a likely occurrence, but there is clearly a difference in the level/support of care offered.

Depends on your GP. Many FM residencies do one or two months of EM and that could very well be the last time they tubed someone. Most GPs aren't going to have the ability to tube someone in their office anyway. I'm pretty sure I can bag someone just as well as a GP can.

I have multiple EM pharmacist colleagues who have been on planes where there were medical emergencies. They don't usually stand up at the first request for a doctor on board, but will at the 2nd. Where they then find out there are 2 or 3 physicians on the plane who didn't say anything at the first call, either.

Ideally you'll have an ACLS/PALS/ATLS trained badass trauma surgeon/intensivist there when the **** hits the fan. But considering I'm PALS and ACLS you'd be better off with me showing up than a 70y/o GP who hasn't practiced outside their office in 40+ years.

 

[Socrates25]

Depends on your GP. Many FM residencies do one or two months of EM and that could very well be the last time they tubed someone.

Sure and most GPs would be reticent to tube somebody in the office or at an accident scene. And while its true that they probably havent tubed somebody in a long time, a pharmacist has NEVER tubed anybody and has ZERO CLUE where to even start. If its a situation where EMS is a long ways out and the patient clearly needs a tube, I know many GPs who would give it a shot. Are they going to be as good at it as an average paramedic? Of course not, but they'll be infinitely better than a pharmacist. Give me a GP any day over a pharmacist in that situation.

Most GPs aren't going to have the ability to tube someone in their office anyway. I'm pretty sure I can bag someone just as well as a GP can.

Really? How many people have you bagged? I've seen pharmacists at codes but I've never seen them bag anybody. Its not as trivial as you suggest either. A first year med student who bags somebody in her first few codes generally uses subpar technique (yes it is possible to bag somebody in subpar fashion) and we're supposed to believe that a pharmacist who has likely NEVER bagged anybody, is as good as a GP?

I have multiple EM pharmacist colleagues who have been on planes where there were medical emergencies. They don't usually stand up at the first request for a doctor on board, but will at the 2nd. Where they then find out there are 2 or 3 physicians on the plane who didn't say anything at the first call, either.

I'd take a GP over a pharmacist any day in that situation too.

Ideally you'll have an ACLS/PALS/ATLS trained badass trauma surgeon/intensivist there when the **** hits the fan. But considering I'm PALS and ACLS you'd be better off with me showing up than a 70y/o GP who hasn't practiced outside their office in 40+ years.

A GP with 40 years of experience has generated a ****load more differential diagnoses than you have pal. Most calls for assistance on airplanes are not full codes and dont require ACLS management anyways.

A 70 y/o GP who encounters a person with difficulty breathing on an airplane will be able to figure out whats going on a lot quicker than you will.

Again, give me a 70 y/o GP with 40 years experience over a pharmacist any day of the week.

 

[pharmschooler]

I wouldn't bother trying to compare PharmDs and MDs. Both serve their purposes and are not interchangeable. I wouldn't go to an MD if I needed an expert on drugs, and I wouldn't go to a PharmD if I needed an expert on illness.

Fight all you want, neither profession is "better" than the other, only different and with different specialties.

 

[owlegrad]

I wouldn't bother trying to compare PharmDs and MDs. Both serve their purposes and are not interchangeable. I wouldn't go to an MD if I needed an expert on drugs, and I wouldn't go to a PharmD if I needed an expert on illness.

Fight all you want, neither profession is "better" than the other, only different and with different specialties.

But pharmacists cannot intubate. Therefore, MD>RPh.

/thread

 

[rxlea]

lulz. The thread that never dies. I would take any medical professional over the average Joe in an emergency situation. But, some people go around "reminding" others how superior they are as they desperately cling to their turf in the face of encroachment. However, this forum is our turf; let's not forget that

 

[njac]

I'm not going on with this pissing match. I think we've all worked with stellar examples of health professionals and scary examples. I'm sure we could all fill this thread with stories of either, but it's moot and it's obvious none of us are changing anyone else's mind.

 

[Sparda29]

Sure and most GPs would be reticent to tube somebody in the office or at an accident scene. And while its true that they probably havent tubed somebody in a long time, a pharmacist has NEVER tubed anybody and has ZERO CLUE where to even start. If its a situation where EMS is a long ways out and the patient clearly needs a tube, I know many GPs who would give it a shot. Are they going to be as good at it as an average paramedic? Of course not, but they'll be infinitely better than a pharmacist. Give me a GP any day over a pharmacist in that situation.




Really? How many people have you bagged? I've seen pharmacists at codes but I've never seen them bag anybody. Its not as trivial as you suggest either. A first year med student who bags somebody in her first few codes generally uses subpar technique (yes it is possible to bag somebody in subpar fashion) and we're supposed to believe that a pharmacist who has likely NEVER bagged anybody, is as good as a GP?




I'd take a GP over a pharmacist any day in that situation too.



A GP with 40 years of experience has generated a ****load more differential diagnoses than you have pal. Most calls for assistance on airplanes are not full codes and dont require ACLS management anyways.

A 70 y/o GP who encounters a person with difficulty breathing on an airplane will be able to figure out whats going on a lot quicker than you will.

Again, give me a 70 y/o GP with 40 years experience over a pharmacist any day of the week.

 

[PharMed2016]

I have actually had this happen at least twice. "Patient's insurance doesn't pay for Avelox, the pharmacist wants to know if you want to switch to Cipro?"

I just assume they didn't bother asking the patient what the diagnosis was or something.

Good thing Levaquin just went generic I think. There's the first respiratory quinolone that's generic.

 

[PharMed2016]

Just read all the comments after the first post on the page, lol.

 

[spacecowgirl]

I'm not going on with this pissing match.

I think this is where the pharmacy curriculum really falls down. Two semesters of pissing technique would have been more helpful than that measly intro class in first year.

 

[Sparda29]

Good thing Levaquin just went generic I think. There's the first respiratory quinolone that's generic.

Really? When did it go generic?

 

[Jabberwocky12]

Really? When did it go generic?

I believe the patent expires this month. So now it's a race to see who gets it out first.

 

[WVUPharm2007]

Cardinal says the 20th...

 

[clachan3]

.

I won't argue with a pharmacist who says that they don't have time to help patients - I am sure that is some people's experience and I am sure it happens. But I know we always take the time to answer questions, make recommendations, and do lots of other things to help people. It's a matter of prioritizes. Who cares if the next person has to wait an extra 10 minutes? If someone needs your help, you help then. It has nothing to do with working at a chain. I don't mean to come after you personally, I just feel like we keep repeating that mantra here to the point where we don't even question it anymore - chains are bad, independents good. You don't have to sacrifice your patients to work for a chain.

I agree I chose to become a community pharmacist instead of working in a hospital mostly because I get to help people on a daily basis. My classmates are saving lives in the hospitals, but I enjoy talking to people and help them with their healthcare needs more. I used to work for cvs, I took the same amount of time to help patients in the store or on the phone as if I was working at my low volume store. I just had to finish what I was doing at the moment and then get out of the pharmacy to help them. I treated it like a break from checking 30-40 scripts per hour. Most of the people I helped didn't mind to wait for a few minutes and are very appreciative about us making the time to help them.

 

[owlegrad]

I agree I chose to become a community pharmacist instead of working in a hospital mostly because I get to help people on a daily basis. My classmates are saving lives in the hospitals, but I enjoy talking to people and help them with their healthcare needs more. I used to work for cvs, I took the same amount of time to help patients in the store or on the phone as if I was working at my low volume store. I just had to finish what I was doing at the moment and then get out of the pharmacy to help them. I treated it like a break from checking 30-40 scripts per hour. Most of the people I helped didn't mind to wait for a few minutes and are very appreciative about us making the time to help them.

But you are a pharmacist...You are supposed to hate CVS.

 

[cephalexinRX]

If you are a narcissist, don't be a pharmacist.

It's that simple.

You won't be thanked. The patient won't know it was you that helped them with a reco. The public thinks we just count by 5s.

Is what it is. Embrace the difference you can make and leave all of that prestige-seeking bull**** at the door.

There are also medical doctors that are not appreciated by the public. They're called PATHOLOGISTS. No, they don't just work with dead people (forensic pathology). They analyse tissue under a microscope and make diagnoses that other medical doctors base their treatment on. Sometimes pathologists even do intra-operative consultations...in the middle of surgery a frozen tissue section is provided to the Pathologist and they basically tell surgeons what to do and why.

Pathologists are the Doctor's Doctor. Most patients don't know.

Alot of the public isn't even aware of the major differences between a tech and a pharmacist.

Same goes in medicine....patients don't know what a pathologist is or think the radiologist is a tech.

 

[Carboxide]

There are also medical doctors that are not appreciated by the public. They're called PATHOLOGISTS. No, they don't just work with dead people (forensic pathology). They analyse tissue under a microscope and make diagnoses that other medical doctors base their treatment on. Sometimes pathologists even do intra-operative consultations...in the middle of surgery a frozen tissue section is provided to the Pathologist and they basically tell surgeons what to do and why.

Pathologists are the Doctor's Doctor. Most patients don't know.

Alot of the public isn't even aware of the major differences between a tech and a pharmacist.

Same goes in medicine....patients don't know what a pathologist is or think the radiologist is a tech.

Did you seriously bump this thread just to contribute THAT? Of all things, THAT?

 

[cephalexinRX]

Did you seriously bump this thread just to contribute THAT? Of all things, THAT?

I didn't realize it was that old of a thread (I'm new).
I work with Pathologists and just wanted to point out that there are medical doctors that remain unthanked since the OP was venting on Pharmacists being "unthanked".

That is all.

 

[owlegrad]

Aww common guys, we don't have to be that hard on the newbie do we?

 

[UES Girl]

Aww common guys, we don't have to be that hard on the newbie do we?

Alright, Ill be nice and delete my post.

 

[owlegrad]

Alright, Ill be nice and delete my post.

 

[owlegrad]

I didn't realize it was that old of a thread (I'm new).
I work with Pathologists and just wanted to point out that there are medical doctors that remain unthanked since the OP was venting on Pharmacists being "unthanked".

That is all.

Welcome to the boards.

And you don't really need to worry about bumping old threads, it is preferred to constantly starting new threads on old topics.

 

[Cloud 9]

Quoted for truth

I don't know but when I grew up on the internet QFT meant quit f***ing typing...Quoted for truth is new to me, haha. I always wondered why someone would say that on here when they meant they were agreeing with someone because I grew up with it having a negative connotation, lol.

 

[Cloud 9]

Did you seriously bump this thread just to contribute THAT? Of all things, THAT?

To be honest I don't know why you're freaking out, I thought the post was quite insightful and nice to add to the discussion...