Are we speaking the same language?

I wonder this often during my workday. The biggest problem being I don't work in a non-English speaking area (kinda). The people in my 'hood speak "English," but the words are severely misplaced. It's sort of like communicating with a schizophrenic on acid. I've never done this per say, but I can imagine it's similar to my everyday struggles.

Case in point: A cute lady comes to the counter. When I say "cute" I mean morbidly obese with a noticeable five o'clock shadow. Yes, I'm being ironic; no, I'm not a chubby, bearded lady chaser. She comes up to me with an empty rx vial (concealed in her fat little hoof) and spews: "Could this be making me feel like I am?" She was quite nervous and agitated. Where to begin?

My mind said:

What the..? Why is your beard thicker than mine? How many calories does it take to be thaaat fat?(she was a 4X4 - 4 feet high, 4 feet wide) What are you holding? What the...? How did you escape from the carnival? God she's hideous, I think I just threw up in my mouth a little...

But my response was: "What?"

Fat Lady w/ Beard: "I've been having jags of fits lately.!..!!"

Me (in head): What the fuck is a jag of a fit?!?

Me: "Okkaaay...."

FLw/B: "Could it be this?" (speaking of nothing in particular)

Me (in head): What the fuck is a jag.......

Me: "What? ..... What are you pertaining (word to big) to?

FLw/B: "Huh?"

Me (in head): Fuck me, where do they keep finding them and why do they keep coming to me?

FLw/B: "Could it be this....?"

This went on for about 10 minutes. She finally revealed her vial and was asking if her BP med was making her crazy. Life had already done it's fair share I'm afraid. After much deliberation, I assured her that her BP med was not the culprit and gave her some suggestions which she appeared to ignore. She came back the next day with scripts for anxiety. I couldn't believe she actually sought the help I advised! What's the moral of the story, you ask? I have no idea and I still don't know what a "jag of a fit" is. I doubt I ever will - neigh, I don't want to know. Just another day in pharmacy paradise.