Kudos and Complaints

Nice compliment from a professor.

   I just purchased the Antibiotic Kinetics program to demonstrate in my kinetics 
   class. You have so nicely summarized the huge variability in vancomycin parameters 
   on this website--may I get permission to copy and paste (with citation of course) 
   into my handout? Thank you!
  


I really don't deserve this, but I had to laugh out loud when I received it.

   You have once again retained your title as "The God of Kinetics"! thanks
  


Kind words from a fellow pharmacist.

   Thanks a million! I love your programs. I switched from Treo's to iPhone's a few 
   years back, and this program has saved me many times. (just as the older applications did!) 
   I appreciate your email and thanks for explaining the set up for me. I will let my 
   other iPhone coworker know what to do.
  


Kind words from a teacher.

   How do I go about getting permission to use some of the info on this site 
   for my graduate students, Pharm course? I find your explainations easy to 
   read and understand for those who are familiar with the concepts for undergrad 
   classes, but have been away from the basics for a while. Thanks


It is very rewarding to receive such nice compliments from a satisfied client.

   I can't tell you how much I appreciate all of the effort that you have put into 
   this.  With any other product there is no way I would have ever been able to 
   communicate with the programmer and most other companies would have had enough 
   of me long before the problem was solved and I would have just had to seek out 
   another product to purchase.  I would and will recommend your product to anyone!


Inspiring words from a fellow pharmacist.

   I really do like your kinetics program, I use it several times a day in my  
   practice, and since I have an iPhone, it is the only application that  
   I am aware of that is compatible with Mac.  In fact, it's what all of  
   the pharmacists at my hospital use.


Publication permission granted, I'm not a great artist but I try :)

   A***S is seeking permission to use the diagrams called:  
   "estimating height from demispan" and "estimating height from knee height"
   to be used in our clinical practice guideline for altered nutritional status. 
   This is a great resource, thank you.


Inspiring words from a fellow pharmacist.

    Rick, I have always appreciated the effort you've put into your  
    programs and they have repeatedly proven themselves in the workplace.  
    I've always thought of you as a pioneer in that regard. Keep up the  
    good work.


Kind words from a fellow pharmacist.

    I've found I can't live without your program. Not sure how many times 
    I have used your program over the past few years but easily in the thousands  
    I'm sure.  I'm also certain that I'm not alone so hopefully it is a nice 
    feeling for you to know that your efforts have clearly been helpful to what 
    must be a huge number of patients not to mention practitioners.  Anyway, thanks 
    again for your suggestions and for such a helpful program.


Trying to keep up with all the changes in software development is frustrating at times, I sometimes feel like folding up shop. But then I receive encouraging words like these from a pharmacy school professor:

   Keep working because so many students get it once they can see it.  
   You have been a help to my teaching!


Praise for the PK tutorial from a recent grad about to take his boards:

  Thank you very much. Your review provides a very nice synopsis of a 
  semester long pharmacokinetics course. Now I feel I have reviewed PK 
  and feel I have a good grasp on the content.


Thanks from Eastern Europe

   Today I installed your upgrade to the APK. It works quite well. Thank you very 
   much for this! Took your hint to use the PDF converter. Actually works flawlessly. 
   Yours very sincerely from the distant and now very cold Poland.


Recent press...


Encouraging words from a long time user

   thank you for wonderful kinetics programs that are reasonably priced and available 
   on so many platforms.


Kind words from a long time user

     Hey Rick, K** C***l and I were wondering how we could get a hold of your Kinetics 
   program.  He and I used them in a prior life… Actually we were sent a M********x 
   version of K*******x and it pales in comparison to your program. Thanks for such 
   a great product.


A complement about TPNassist for Palm

    Rick I really think you have a good product here.  I am encouraging the other members 
    on the nutrition team to purchase a copy.  It certainly reduces the mistakes and helps 
    in calculation of dosages. 
  


Kind words from a loyal long time user

   I am probably one of the very early users of your Kinetics program....
   and I am still using it 15 years later.  One of the really fantastic parts 
   you added over the years was dosing for various renally cleared drugs
   ....Thanks!


More encouraging words

   Rick, I wanted to tell you how beneficial your program has been for us.  
   We do the kinetics on all vancomcyin and aminoglycoside orders, and 
   rewrite them without doctors cosignature, under protocol.  We searched 
   for a suitable program and found yours was just what we needed.  Easy 
   to use and accurate.


Kind words from a fellow pharmacist evaluating currently available PDA PK calculators:

The Pocket Pharmacist: Pharmacokinetic Calculators


When I begin to doubt myself and wonder why I took on this huge responsibility, I remember this comment I received last year from an Austrian physician:

    Rick:
    Thank you for the Cefepime model, it really helps a lot, seizures 
    have disappeared from our institution.  


Kudos from vet students

   hey thanks for maintaining this site it is a great help for us vet students!         


Kudos from across the sea

   Vielen, vielen DAnk! Sie haben mir viel Arbeit erspart!


Nice feedback from a student

      Thank you soooooooooo much.  It is an incredible site.  I'll be 
   tested on this topic shortly and your site makes the whole concept 
   so much easier to understand.  It's very concise.


Kind words from a pharmacy director

      Rick - 
    Just wanted to let you know how impressed we are here at E** with both 
    the kinetics and tpn tutorials. We are very big on education here (in fact 
    we have a part-time pharmacy educator position). Most new pharmacists go through 
    8-12 weeks of orientation before they are "on their own". We are currently 
    expanding and standardizing our clinical training and are incorporating both 
    of your tutorials in this process. They are excellent training tools.

    I wasn't sure if you've had much feedback on these and I wanted to make sure 
    you knew just how helpful they are.


And then along comes this internet naïve guy, who obviously is having a bad day, and decides to take his frustration out on me.

      Your web site is the pits including this email function.  I have typed in 
   information 5 times and have no indication if i have been successful in ordering 
   labels, APK and drip charts.  This my second attempt to forward this email.  I 
   did not type my affiliation, so every thing i have done after that ommission has 
   been obliterated.  If your software performs like this site, I am making a big 
   mistake.   Please let me know if I have ordered anything. I know i have not paid 
   for it because the cc section never recorded any of my transactions.

Thank goodness his order never went through!


Words of support from an old colleague

 
     Rick long time no see.  I have just left ******* and am now Director of
   Pharmacy at S**** Memorial Hospital starting this week. This is a not for profit 
   hospital located on the Eastern Shore of ********.  One of the reasons the hospital 
   hired me was for my experience in starting clinical programs.  This is my second day 
   on the job and I have already found that the hospital does not have a good kinetics 
   program.  I told my VP that I know of an excellent program that will be liked by both 
   the medical staff and the pharmacy staff and he gave me the OK to purchase the program.
   Please send me a formal quote so that I can get it approved for purchase. 


Kind words from a teacher

 
     Hi Rick -- I have looked at your programs before and want to teach my 
   Clinical Pharmacokientics course using them.  I will put a link and 
   information for them in my course area on Blackboard.  There are 127 
   students in the course so you may be getting a number of requests in 
   the near future.


Encouraging words from a teacher

 
     I find your nutrition tutorial very helpful for my students. I thought 
   I could send more than $5.oo with Amazon. Do you have Paypal? I'd like to 
   send some additional funds.  Thanks


More kudos from a teacher

    
      I am a PharmD in ###, ###. I will be teaching a class in pharmacology 
   in the fall for neonatal NNPs.  I really like your on-line tutorial and 
   was wondering if it would be okay to use/recommend your tutorial for my 
   students. 


A compliment from a nursing school instructor

   
   I am requesting permission to use two slides and select text from your nutritional
   support tutorial. J******** C****** is a community college south of S******, M*****.  
   We have both an LPN and RN nursing program.  One of my courses is the GI system 
   and we have a small section on malnutrition and obesity.  Your material is 
   excellent for that lecture. 


Kind words from a student

     Thank you for providing a wonderful program with the option to test it out 
   freely prior to registering!


Another nice complement

      I love this program. I am involved in a rural family practice residency 
   program for 2nd and 3rd year residents and it really comes in handy


More encouraging words

     All the clinical pharmacists love your program and want me to now 
  put it on the network for all of us to use. 


More kind words

     Your program is fabulous. It hit the vanco trough right on for a 
   500 lb patient.  Thanks!


Another nice complement

      I work in the Childrens' Hospital at *** and before I got your program 
   I was doing all of my kinetics by hand. Your program is awesome and it 
   saves me alot of time! Now I only crunch numbers on the less than 2kg 
   babies. The program works wonderfully.


Today I received a nice email, it's very encouraging to hear things like this:

      I just wanted you to know how useful your website is.  I have spent 
   the better part of a day looking for appropriate information on TPN to 
   support a group of nurses who will be getting their first TPN patient 
   this week.  Yours was the first and only website I found with precisely 
   the information I needed.  Thanks.


Kind words from a fellow pharmacist:

       Rick, your software is miles ahead of what we're using now, it takes the 
     headaches out of kinetics.  Your website and tutorials are excellent!


Kudos from a fellow pharmacist:

     Rick, your software is the best I have found on the market, including overpriced 
   entries from M********* and A***.  


I check my web logs periodically to see how people happen to stumble across my little corner of the internet. It's usually through a search engine such as google, but this time I found several hits coming from a page at auburn.edu. So I visit the site and find a "review" of the Antibiotic Kinetics for Palm program. It's a real hatchet job by a group of highly critical, opinionated pharmacists. After reading it, I'm surprised I received any hits at all. The most frustrating part is, not one of their criticisms is true.

Criticism #1. Frustrated by need to enter patient demographics which are not needed if you have drug levels.
Reply - Patient demographics (age, ht, wt, gender, SCr) are necessary to calculate the population model used with Bayesian analysis.

Criticism #2. Lack of conversion, forced to use cm/kg not in/lb.
Reply - This is available after you register the program, it is a carrot held out to entice you to register.

Criticism #3. Difficult to know which button to push, wasn't worth the time to figure out.
Reply - Unfortunately, the small size of the Palm screen requires the use of abbreviations. The program has help for each screen which explains every detail. Some screens have a "?" button for help, all others have help via the Menu. Otherwise, everything is explained in the manual.

Criticism #4. No adjustments for ODA aminoglycides, I could not find a setting to change mg/kg.
Reply - Every model parameter, including the "mg/kg" ODA dose is on the model editing screen. Please refer to the user manual.

Criticism #5. No Hartford nomogram.
Reply - Yes there is.

Criticism #6. Vancomycin dosing is overkill.
Reply - That is your opinion, why is that a criticism of my program? It's there for the people who do want to dose Vancomycin using a pk model. If you don't want to see it, you may delete it from the model database.

Criticism #7. Very few clinicians measure peaks, much less the 2-3 levels required to perform retrospective dosing.
Reply - The program is very flexible, you can evaluate a single level using Bayesian analysis, or up to 4 levels around a single dose. Pharmacists use many different methods for performing pk analysis, this program accommodates them all. Again, this is explained in the manual.

Criticism #8. Aztreonam, Ceftaz, and Netilmicin are useless and should be eliminated.
Reply - Again, that is your opinion, why is that a criticism of my software? I included these drug models to show how flexible the program is, that it could be used to model 1-cpt drugs other than AG's. A 1-cpt model of Aztreonam can be very useful when dosing patients with renal impairment. Again, you can add or delete any drug using the model editing screen.


I am at my desk on a quiet summer day, when I receive a call from an obviously stressed out pharmacist. "Your software is WRONG" he screams at me. "What do you mean?", I replied somewhat sheepishly. "The creatinine clearance your program gives is completely wrong.", was his reply in a most indignant tone. I mentioned that the difference was most likely due to the weight he was using in his hand calculation, that the program uses lean body weight, and that this was one of the FAQ's on the website. "All right", he says as he slams down the phone. About 15 seconds later I get another call from the same fellow. "I put in lean body weight and it's still wrong". I try to explain that he doesn't have to calculate lean body weight, that the program performs these calculations automatically and uses the appropriate weight. By now the guy is coming down off of his adrenaline-fueled rage, and mutters a reply, "I was just thrown into this job and haven't been trained, I guess I don't know what the hell I'm doing." I mentioned that the pk tutorial on the website might be helpful.

I never heard back from this particular pharmacist, but hardly a day goes by that I don't receive the same question from someone under a little less duress. The Cockroft and Gault equation is one of the most commonly used, yet least understood calculations in pharmacy. I'm afraid that for every pharmacist who questions me, there are ten who don't bother to ask, and who believe "this software stinks".


Today I received another nice email:

      Just a word of Kudos on Freekin--- you have a great ability to simplifiy
    such complex material for us lowly  clinicians to really be able to use it!
    Thanks for the great software, and the great website that explains it all!


Last year I fulfilled an order for APK from a pharmacist at a Colorado hospital. Four months later, after not receiving payment, I emailed him a gentle reminder, asking if there is a problem, otherwise, to please see about payment. His blunt 3 word reply was, "Send an invoice". I obliged by attaching a copy to the reply email. A couple of weeks later I received a check from the pharmacist himself, NOT the hospital. The amount of the check was less than the invoice, and he had scribbled a nasty note across the invoice, "Your software is junk, the results are not accurate." I tried several times to reach this fellow to find out just what he meant, but he never replied. So much for professional courtesy. Fortunately, there are only a few bad apples. Most pharmacists I've dealt with are courteous and friendly, and realize that any software is only as good as the person using it.


A few days later I receive this email and I remember why I do this:

    Rick,
       First off thanks for providing a great  kinetics program.   We have 
    been using APK house wide for a few months now, and our electronically 
    timid RPhs are finally realizing the power contained in this program.  
    I get daily internal emails of a new pharmacist that has had a Palm 
    Epiphany, and finally realizes what they can do.


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