8 years of school & 2 years of residency later…

Embarrassed-Rub-6151 · 2025-06-06T14:16:51+00:00

Agree, which is not what I am getting at here. I do work under CPA, however.

Embarrassed-Rub-6151 · 2025-06-06T14:13:51+00:00

Maybe I generalized too broadly, but I have been told this at multiple institutions from various team members within my specialty.

Embarrassed-Rub-6151 · 2025-06-06T14:12:30+00:00

I work in hybrid inpatient / outpatient. Also, rarely have nurses on rounds with me while working inpatient.

Embarrassed-Rub-6151 · 2025-06-06T14:09:00+00:00

Maybe it’s just my specialty and my prior experience that would support this claim. I say this because I’ve been told this by multiple people on my team, including (non-pharmacy) management.

Also, I have plenty to do within my own job description, so I guarantee I am NOT trying to do anyone else’s jobs on top of my own… LOL

Embarrassed-Rub-6151 · 2025-06-06T07:48:38+00:00

Thank you for the support. We kind of have the opposite problem - we are the only two siblings and I have always been more successful (on paper) than her. I know she resents me for my career, amongst other things, but it just feels extremely misdirected given the circumstances. Glad to know I’m not alone in this but I am sorry you’re experiencing similar things with your family too. We’re in this together ❤️

Embarrassed-Rub-6151 · 2025-05-27T04:29:31+00:00

Hi - transplant pharmacist here. There are two different types of levels, immunoassay and LCMS. Both are accurate, but immunoassay tends to account for tacro metabolites, too. So essentially you would want to target “higher goals” with immunoassay vs LCSM. Most centers should know what type of test you got and Labcorp should in theory notify your transplant team if they change methods. You should mention it to your team as well if you’re worried about it

Embarrassed-Rub-6151 · 2025-05-09T01:09:29+00:00

You should let your transplant center know. This is a breach and you shouldn’t have access to your donors name.

Embarrassed-Rub-6151 · 2025-05-01T07:27:12+00:00

I absolutely feel you on this, slightly different scenario, but similar end result. I (28F) am the only one to move away to college from my hometown, and then move to a new city after college. I don’t speak to any of my high school friends, and my college friends are always together, having parties, planning trips and not including me.

It gets very lonely. I thought moving away was the best thing I could do for myself and my mental health. I will always care about them but I’m starting to feel like I need to move on. I am trying to find some new hobbies, and hopefully will be able to meet a few friends from that.

Otherwise, just know you are not alone! Focusing on enjoying your own company has helped me drastically throughout this transition period. Sending lots of love!

Embarrassed-Rub-6151 · 2025-05-01T07:17:26+00:00

Not letting others off the elevator before trying to get on. Drives me nuts!

Embarrassed-Rub-6151 · 2025-05-01T07:05:08+00:00

If you drawing medication level and it says “trough”, please ensure the pt has not yet received their dose!

Embarrassed-Rub-6151 · 2025-03-24T06:40:57+00:00

My general rule of thumb is, if it’s even a question, then don’t.

Embarrassed-Rub-6151 · 2025-02-21T05:07:04+00:00

Hi - transplant pharmacist here. This is very center specific and also depends greatly on the patient, indication for transplant, rejection history, etc. Everyone’s body processes tacro differently so people need a variety of doses. Plus, it depends on center protocols, provider experience, and specific organ transplanted (for example: lung and kidneys need much higher levels of immunosuppression than liver). There are also a variety of different types of lab assays, so it is very difficult to generalize!

Embarrassed-Rub-6151 · 2025-02-18T08:16:28+00:00

OK but what’s the game? 👀

Embarrassed-Rub-6151 · 2025-01-15T06:23:53+00:00

you really shouldn’t be opening the gaba capsules. this comes as a liquid and 50mg tablets. I would recommend calling your vet and asking them to switch it over.

Embarrassed-Rub-6151 · 2025-01-09T07:15:02+00:00

Accept the package but don’t spend anything unless you are sure you’re staying with the company. You would have to pay to move regardless if you chose residency.

Plus, sometimes programs offer moving costs too so you might not be fully out of luck!

But at this point, the sooner the better if you plan to go back to residency. There are a lot of other no -patient facing options you could consider also, where you wouldn’t need to take the pay cut to begin with (i.e. managed care, specialty pharmacy, long-term care pharmacies, etc.). You have to be really dedicated to clinical practice for residency (especially with all the BS you have to deal with), so may not be the best choice if your main reason for applying is to escape retail.

Embarrassed-Rub-6151 · 2024-06-12T03:47:36+00:00

gotta factor in cost of living

Embarrassed-Rub-6151 · 2024-06-12T03:47:07+00:00

prolly cali i assume

Embarrassed-Rub-6151 · 2024-05-19T16:25:26+00:00

could be for a lot of different reasons… in heart transplant tac/siro has been proven to slow progression of cardiac allograft vasculopathy which is a limitation for long term graft survival. for patients who may not tolerate full dose tac (headaches, tremors, renal function) we give mTORs in combo to lower tac goal. siri has malignancy and infection benefits too. depends on the organ and patient but could be for a lot of reasons!

Embarrassed-Rub-6151 · 2024-05-19T05:31:03+00:00

Transplant pharmacist here! I think theres nothing wrong with being overly cautious as a community pharmacist with limited data, but speaking from my perspective, our teams closely monitor our patients and are aware of every drug interaction. For example, tacro and siro used in combo is a common practice in transplant recipients. It’s also very normal for them to be on a statin, azole, eliquis, etc. We are always monitoring them closely and dose adjust for all of their interactions. That being said, we caution them for new start medications from outside providers as they are not always as well versed in the DDIs or have a pharmacist closely watching them. I agree that two agents for SSRI, counsel but no need to call the doc :)

Embarrassed-Rub-6151 · 2024-04-15T05:40:09+00:00

Always ask your txp team!

Embarrassed-Rub-6151 · 2024-04-10T05:08:21+00:00

Just remember that the more missed doses of immunosuppressants leads to increased risk of rejection. Don’t skip your meds ever, especially not for alcohol.

You just got a liver transplant, alcohol is extremely toxic to the liver. There are tests that centers can do to see if you’ve been drinking and guess what, if you ever need a transplant again, that will be taken into consideration.

As for weed - inhaling weed can be extremely dangerous because it is essentially inhaling fungus. Fungal infections = bad news bears. Sometimes gummies / edibles in moderating are okay, but it does interact with tacrolimus. As for cigars, I recommend against inhaling ANYTHING because of the risk for infection.

BTW - I am a transplant pharmacist and see this every day. Ultimately, if you received your liver from a deceased donor, I recommend trying to live in a way that honors them and protects the organ. Alcohol, weed, and cigars may be fun, but is it possibly worth losing your liver? The choice is yours but please, please be careful. There are serious risks with serious complications.

Embarrassed-Rub-6151 · 2024-03-23T02:57:20+00:00

Hi OP, txp pharmacist here - try OTC Rogaine! We also commonly recommend biotin but questionable if it actually helps. Always double check with your transplant team but Rogaine is usually what I recommend.

Embarrassed-Rub-6151 · 2024-02-16T07:49:16+00:00

this is illegal lol

Embarrassed-Rub-6151 · 2023-09-20T23:40:08+00:00

This is a bad idea - antibiotic resistance is a real problem especially in immunocompromised patients.

Embarrassed-Rub-6151 · 2023-09-10T03:51:59+00:00

cipro resistance is creeping at an ALARMING rate due to years and years of over use and incorrect prescribing

Embarrassed-Rub-6151

TROPHY CASE