Pharmacist delivers hope in small doses

SANDPOINT — There is a tiny little corner of Bonner General Hospital (BGH) where, according to some people, Mary Snider is working magic. The compounding pharmacist has built that reputation by developing custom medications that generate waves of gratitude.

Men give her kudos for helping their wives, women credit her with giving them their lives back, parents thank her after healthy children are born and adult children do the same when their own parents reach the end of life without pain.

Snider runs a small, very different kind of retail pharmacy called Bonner Professional Compounding. The business first was formed in 2002 to answer a need for pain management medications for Hospice patients nearing death. Those individuals still represent about 50 percent of her business.

“There are so many rewarding stories,” the pharmacist said. “I had a Hospice patient who just wanted to crochet until the end of her life. I was able to develop a cream that took care of her hand pain from neuropathy so she could do that.”

Bonner Professional Compounding was the first hospital-based pharmacy of its kind in the U.S. and is still one of only two in the nation. And while it’s a bit of a challenge to find — located around several jogs and turns along the second-floor hallways of BGH — the little office adjoining the hospital’s main pharmacy has turned into a place where clients first come to discuss their needs and later return to applaud the results.

“This is the warm and fuzzy of pharmacy,” Snider said. “We get all kinds of positive comments.”

“She has a loyal following,” said Mauria Prince, pharmacy director for BGH. “Mary has been able to think outside the box and come up with things that aren’t commercially available. Her work in things like wound care and pain management has been impressive.”

When a throat cancer patient was unable to swallow or use liquid sprays, Snider concocted medication that could alleviate pain and promote healing in a dry powder application administered with a “snifter.”

Custom pain medications or antibiotics are also developed as topical creams or suppositories for small children who can’t swallow after a tonsillectomy. There are medications tailored to the individual requirements of patients with diabetes and arthritis, as well.

One of the main growth areas for Bonner Professional Compounding, however, has been in the area of hormone replacement for both men and women. Snider said the field is still considered to be controversial by some health care professionals, but added that her work in low-dosage, specifically tailored medications takes a different approach from what has been available in the past.

She has been especially gratified with the results — and reactions — from women going through menopause.

“There are many women out there who feel like they have no hope,” Snider said. “If nothing else, I’m here to give them hope that you can have that quality of life back.”

Word has spread among physicians and their patients to the point where Snider is a recognized figure even when she’s out of her white coat and on the other side of the counter.

“You can’t go anyplace where people don’t know her,” Prince said. “Women come up and say, ‘You saved our marriage’ and men are coming in to ask for her card.”

The need for custom dosages and application techniques has carried Snider into other interesting areas. In one difficult pregnancy, her medication helped a young mother go full term and have a healthy baby. The mother of a pediatrics patient who wasn’t growing at a normal rate relishes her visits to the compounding pharmacy, where she and Snider celebrate each new inch in the child’s height.

The work also has taken her to unexpected places, including veterinary medicine.

“I treated a falcon who needed an antiviral,” Snider said. “I put it in a tropical fruit-flavored suspension so the bird would take it.

“There’s a little dog in Bonners Ferry that needs to be on high blood pressure medication,” she added. “The parents — I mean, the owners — look forward to getting that package when we send it up there to them.”

Based on a physician’s prescription, Snider researches medication options and consults with health care providers. She also taps into an online network of more than 25 consultants through an organization called the Professional Compounding Centers of America, where information about effective treatments and new breakthroughs is shared.

That knowledge, combined with her own experience, often leads to solutions that don’t exist in products available from the giant pharmaceutical companies.

“Dosage used to be one-size-fits-all,” Prince said. “Compounding has the ability to come up with lower doses and safer outcomes. Now the pharmaceutical companies are following suit to try and compete.”

Apart from those who have found Snider’s little known corner of health care within the broader reaches of the medical world, the unique service remains an undiscovered entity.

“Most people have no idea we’re here, because it’s not your typical pharmacy at all,” she said.

Even physicians, at this point, are only partly aware of what’s available. Still, they are starting to access the compounding pharmacy at BGH more often when they find that standard medications don’t fit the bill.

“I have one doctor that tells patients, ‘Go see that voodoo pharmacist,’ ” Snider said. “I take that as a compliment.”