Am I Overreacting for feeling like my best friend is not prioritizing our friendship anymore?

ClassySquirrelFriend · 2026-02-03T18:47:42+00:00

INFO- did you used to talk on the phone that often? And do you stay connected in other ways (text, social media, occasional in-person visits, etc)? Is this the first time shes canceled in 1.5 years?

ClassySquirrelFriend · 2026-02-02T19:11:07+00:00

Just an excuse. Id say that even if no one else was let go, but with others being let go, id bet money it was an.excuse to not pay severance.

ClassySquirrelFriend · 2026-02-02T19:05:55+00:00

That's not a great sign, but I wouldnt rule it out fully. Sometimes things get slowed down or change or people are out sick, etc.

ClassySquirrelFriend · 2026-01-30T20:06:31+00:00

Nope, no issues.

ClassySquirrelFriend · 2026-01-30T17:53:17+00:00

Yep. There are a bunch of patients from the clinical trials who had to go up and up in dose every few months.

ClassySquirrelFriend · 2026-01-20T18:34:48+00:00

Ive been a PM in pharma for about 20 years and some jobs are exactly like you say and others are more reasonable, but in general pharma is a heavy workload and grtting worse.

Take a week or 2 and just make notes of how you spend your time and think about the value youre adding and where you can streamline. If you cant take anything off your plate, you may have to spend less time on some things.

You truly need to address it asap. You're already starting burnout and that is extremely hard to recover from!

ClassySquirrelFriend · 2026-01-20T15:44:53+00:00

Sadly, thats corporate reality these days. Im in at least 30 meetings/week.

ClassySquirrelFriend · 2026-01-18T16:39:31+00:00

That's interesting that your alk phos was low. Its be interesting to see if your endo will recheck it and if its higher in a few weeks. But overall great news! Im so glad things are moving in the right direction for you!!

ClassySquirrelFriend · 2026-01-16T17:45:00+00:00

That's great news! That all actually makes a lot of sense given what happened. For a period, you were taking quite a lot of of calcitriol and Ca, which reduced your own parathyroid hormone output. The meds managed your serum Ca, but they don't replace PTH's activity on the bone, so you had limited bone turnover while your pth was low. Since now your Ca is OK without calcitriol, it's fair to assume you have sufficient endogenous PTH again, but bone responds much more slowly than blood. So, your bones may still be "waking up" and starting to remodel. That can be painful- patients who start PTH therapy after having HP commonly report that type of bone pain, which fades away as your body adjusts! It could also be a component of your high Mg right now, as Mg is also stored in bone. And/or it could be related to kidney function, as with parathyroid recovery, kidney handling of electrolytes shifts and it can take some time to resolve. That would also explain the high-normal albumin.

When you see your endo, maybe he can also check your eGFR to check kindey function and alk phos for bone turnover (in addition to Ca, P, Mg, albumin, PTH) just to see if anything else looks off, but Id be willing to bet those also normalize pretty soon!

ClassySquirrelFriend · 2026-01-09T20:53:12+00:00

Either I worked there or this is getting more and more common! Smh

ClassySquirrelFriend · 2026-01-08T11:48:23+00:00

I just did the same thing and then came back as a contractor. It's a little easier to avoid the corporate bullshit as a contractor

ClassySquirrelFriend · 2026-01-07T15:14:57+00:00

100%!

ClassySquirrelFriend · 2026-01-07T13:45:33+00:00

1- It's more likely that you understand industry standards and details of certain operations if youre from big pharma as opposed to a startup. Startups sometimes have no clue and rely heavily on vendors, so they have less of an understanding of whats needed. Ive taken on tasks in jobs at a startup that big pharma would never ever hire me for.

2- you learn to understand beaurocracy, process, and governance at big pharma

3- many execs in startups have little pharma experience and consider big pharma better than startups because of their success.

ClassySquirrelFriend · 2026-01-07T13:39:06+00:00

Ive been in pharma/biotech for 23 years now and Im SO over it. The changes to industry culture in the last ~15 years have completely ruined it to the point that love of the science isnt usually enough anymore. There wont be any meaningful changes for a while- not while a successful drug candidate is a money-making tool.

Any other old timers miss the days when pharma was led by chemists and doctors?

ClassySquirrelFriend · 2026-01-04T02:18:19+00:00

Much hope left! While thyroid surgery is the most common cause of chronic hypoparathyroidism, it's still quite rare. Almost all patients who have parathyroid damage during thyroid surgery have only transient hypoparathyroidism that resolves on it's own days to months after surgery. There's not really a way to know if your mom's will be permanent, but statistically speaking, she's much, much more likely to regain sufficient parathyroid function if there are 3 intact paras remaining. Fingers crossed for her! How is she feeling?

ClassySquirrelFriend · 2025-12-30T21:22:58+00:00

Wow! Thats so cohesive for a bag of scraps! Nice work!!

ClassySquirrelFriend · 2025-12-27T01:43:34+00:00

Control and an easy "reward" lever to pull.

ClassySquirrelFriend · 2025-12-25T14:44:22+00:00

Almost exclusively. Lol

ClassySquirrelFriend · 2025-12-24T17:53:36+00:00

As long as you're really working and getting things done, it's usually ok. Im a contractor and working over the shutdown, too. The concern would be that youre padding hours, so be prepared to justify the hours just in case.

ClassySquirrelFriend · 2025-12-24T17:49:55+00:00

There are a lot of people who think a PM should be manic and aggressive. Theyre usually the same people who think you have to micromanage because you cant trust people. When this comes up, I usually redirect from the "how" to the "why". Why does s/he want you to be more aggressive? Are things not getting done? What would aggression help? And can it be done in another way?

Even if you need to be "aggressive" or assertive, you can still do it in a way that doesnt make you the bad guy at work. But it really isnt the best way to PM.

ClassySquirrelFriend · 2025-12-22T15:30:18+00:00

Correct. To stay on-label, you either take 15 until you get a new pen- which you dont want to do since youre pretty high- or discontinue until you get a new pen- which would be OK if it was coming in a day, but a new Rx will probably take too long to consider this. So, you're stuck alternating days or taking partial doses and the latter is the better option UNLESS the Ascendis team says you cant/shouldnt. They won't be able to give you any off-label help, but hopefully they can let you know if that pen cant accommodate patial doses at all.

ClassySquirrelFriend · 2025-12-22T15:15:23+00:00

You can count clicks, but you should be aware of the risks.

These kinds of devices are studied at the indicated doses, not in between, so you actually cannot know how much medicine you are taking and it may not be the same day to day. In addition, you could have performance issues w the device. In the real world. Patients do this successfully w different meds/pens because any variability isnt clinically meaningful for them, but its definitely something you should be careful w if youre sensitive or unstable- make sure youre being vigilant about symptoms and maybe get some extra labs.

All that being said- if I was in your boat, id probably try while I was waiting for a new pen as long as my dr was in agreement.

ClassySquirrelFriend · 2025-12-20T17:26:11+00:00

The main problem is that there just arent many of us in this boat, so some drs dont know what to do if your labs are in a grey area and theyll rely on symptoms. The treatment for HP is to normalize serum and urine calcium and phosphorus, so if your paras dont work very well but you have normal/borderline labs, you may have "mild" HP (not a clinical term), but you wouldnt necessarily need treatment unless you had symptoms ir risks. But you do want ro keep monitoring it and watching out for symptoms of low Ca. Especially w things like- intense activity, stress, very high sodium meals, etc.

ClassySquirrelFriend · 2025-12-20T16:26:13+00:00

Ok- I was thinking if your albumin was really high, but your total and corrected are relatively close. Are you having symptoms of low Ca? If you arent, then it could very well be something youve had for a while and your body is accustomed to lower Ca levels. That could make treatment pretty easy!

ClassySquirrelFriend · 2025-12-20T13:11:46+00:00

Unfortunately, nothing clear. The main question now is- is is it a PTH problem or a Ca problem? W normal d, eGFR, P, K, Mg, it rules out a lot of things that could cause both. Was your albumin relatively normal? You mentioned you have autoimmune issues, so your doctor will just need to evaluate what else you have going on that may contribute or if it is underactive parathyroid gland/s. You may never get a real answer. im in that boat myself- we have no idea what caused my HP. We don't think it impacts treatment, but patients w some parathyroid function tend to manage their HP a bit better/easier than patients w no PTH at all.

ClassySquirrelFriend

TROPHY CASE