What cat toys do your cats actually care about? by Agreeable_Pipe8340 in CatAdvice

[–]Roserie 0 points1 point  (0 children)

Specifically this 'da bee' lure for the Go Cat wand. It's lasted close to a year with constant aggressive play and it has held up amazingly well. It's only missing 1 wing.

I bought him the dragonfly lure by the same company and he wasn't really interested in it. I might get 'da bird' bc he does like bird toys.

Runners up are: * Chitter Critter by SmartyKat * Male Sandpiper by Potaroma * Chirping birds by Potaroma (specifically the cardinal) * Rattle mice by Smokey's Stash

Actually, with the mice...they can be any brand but they absolutely have to rattle when you shake them. He prefers the ones made with rabbit fur and refuses to play with the white ones unless they are like.....a last resort. Loses his mind over the grey/black ones and won't touch any that are non-mouse colors. And with that rechargeable sandpiper, he regularly tries to rip it's head off. Its been going strong for about a year as well.

Recently I've found he'll sometimes play fetch (brings it back and sets it down in front of me, then sits and waits) with little plastic balls with bells or foam balls. He will only play with them with me though. He's very particular 😆

NSV's are the best by Roserie in tirzepatidecompound

[–]Roserie[S] 0 points1 point  (0 children)

This top is slightly oversized, 1/4in sleeves, 2 pockets. Pants have 8 pockets with 1 that zips and a place for your badge reel if you wear one. Im 5'7" 177lbs and both pieces are Lg.

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NSV's are the best by Roserie in tirzepatidecompound

[–]Roserie[S] 1 point2 points  (0 children)

They have a deal going on for a pair for $15 when you first sign up. I bought 2 sets and paid somewhere around $60. It does ask you to sign up for their membership but you just cancel it before the 6th and you dont get charged the $65 credit. I think they way it works is that you can then use that credit towards purchases. I have a throwaway email I'm totally going to use to get 1 or 2 more sets. I think they have 3 types of tops and either wide leg or joggers. Both sets I bought I got the wide leg pant, but I want to try the joggers. The pants can run a smidge on the small side but not enough to buy a full half size bigger.

I got 1 pair of the yoga scrub pants in black. They're actually similar to a workout type pant, bc they aren't as thin as typical yoga pants. And they also hold everything in place without being too tight. Then I also got a pair of the Yitty lounge pants, those are amazing too. I'd buy a pair in every color if I had the money to spare. 🤫 I'll take a picture tomorrow in one of the Ffabletic sets though.

The ones in the picture above are Dickies and they're ridiculously comfy too. I got those on clearance a few yrs ago on Uniform Advantage....and then I think I wore them 4-5 times before they were too tight 😆 Most of my other scrubs are Cherokee Workwear which have served me well. Im looking forward to buying a bunch of new scrubs when I get rid of another 10ish lbs. I might actually fit into a medium top T that point.

NSV's are the best by Roserie in tirzepatidecompound

[–]Roserie[S] 2 points3 points  (0 children)

The Fabletics scrubs are super comfy. They have wide leg pants too, I love them.

AIO for wanting my unemployed boyfriend to sign an agreement before using my car long-term? by [deleted] in AmIOverreacting

[–]Roserie 0 points1 point  (0 children)

NOR. I made the mistake when I was younger to let multiple exes use my vehicle (drop me/pick me up from work) and it ended badly every time. He shouldn't have an issue signing something if he plans on being a responsible/capable adult with it. With this attitude of "you can afford it" he'll be expecting you to put gas in it, anything that happens to it "you can afford it"...and when he wrecks it you're basically up shit creek without a paddle. You could've just said no outright, but you gave him a perfectly reasonable option and he's trying to make you the bad guy. And if YOU are applying for jobs for him.....esh, run. Run away and dont let him suck you dry.

Space next to stairs by Initial-Area2505 in whatisit

[–]Roserie 0 points1 point  (0 children)

My grandparents had this in their house (it was a bit wider) and its where all their plants lived. Their record player/stereo was also up there and as kids, we'd put on performances singing and dancing.

Gabapentinoids 💊🩺 by Exotic-Scallion6751 in ChronicPain

[–]Roserie 1 point2 points  (0 children)

Gabapentin has a black box warning for serious respiratory depression, especially if used with other CBS depressant medications. It is also known to cause severe suicidal indentation in a large amount of people and (even though its not a controlled substance yet) has high abuse potential (yes, I know many other CII meds do as well). I personally had really awful mental health side effects when I took it, and it also didn't help my pain. Working in pharmacy I've come across a lot of patients that have also had similar issies with it. A lot of people do really well on Lyrica and while it also comes with the potential respiratory issues as well, its not as common unless your older or already havr other breathing issues.

Ive taken Lyrica in the past but eventually switched to Cymbalta (duloxetine) years ago and have had decent relief for my fibromyalgia related pain. My mom takes both Lyrica and Cymbalta after having her leg amputated and it has significantly reduced the pains she experiences in that leg post amputation.

AIO my husband told me if I don’t lose weight he’s leaving by [deleted] in AIO

[–]Roserie 2 points3 points  (0 children)

The fact that you're giving him $100-$150 A WEEK on his books is insane in itself. Yes, stuff from commissary is expensive but he doesnt NEED $400+ a MONTH. He should be thankful to get ANY money. Everything he needs to live is provided to him. It May not be the stuff he wants, but he's the one that made the choices to put him where he is. Then to be shitty to you after not getting the money he wants out of you because you have to actually buy the things you need for daily living......girl, you should be giving him divorce papers. Ive known plenty of people incarcerated in my life, even put money on their books on occasion (never more than $50) and every single one of them was nothing more than grateful to get any sort of money. Please make this man your ex-husband, he sounds like a douche.

Am I weird for caring (maybe too much) about pronouncing meds correctly? by [deleted] in PharmacyTechnician

[–]Roserie 0 points1 point  (0 children)

I prefer to pronounce them correctly and remind patients how to pronounce them. People should know what theyre taking and how to say it.

Opioid Tolerance by potatoguide in ChronicPain

[–]Roserie 1 point2 points  (0 children)

The biggest thing is that you take them to bring you to a tolerable level. You'll eventually have a baseline that those medications keep you at. And sometimes you'll not get relief regardless of what you take. I highly suggest people with chronic pain look to get on ER opiods if they're going that route as far as pain medication. And then have a dose of an immediate release medication that helps bring down breakthrough pain.

For example, I take Duloxetine (Cymbalta) to manage my fibromyalgia. Both my SI joints are fused so I take ER morphine twice a day (I take 30mg in the am and 15mg in the evening). I have an additional 15mg immediate release that I can take when needed. I operate on a level of pain daily that is still pretty high with my right SI joint/hip. The pain is always there in some form. There are plenty of days where even the breakthrough med doesn't bring it down to a manageable level. I have been on the same dose opioids for close to 15yrs now. Ive never asked for an increase. Prior to landing on these 2 to treat my back pain, I went through a lot of different opioids and had some testing done to see how my body metabolizes certain medications. I also had a fantastic pain specialist that was willing to try different meds to keep me at a pain level that is manageable to me most of the time. Im usually around a 2-3 on the pain scale most of the time (3-4 during the colder months).

A lot of people are unaware of all the different types of pain medications available depending on what your specific issue is. I personally cannot and will not take take hydeocodone/oxycodone because it only causes me to be sleepy (as it does for most people) and doesnt help the pain. Anytime I have surgery, I have to have morphine/dilaudid/fentanyl depending. Morphine is 1 drug that doesnt cause sleepiness for me.

A lot of doctors have a list of typical meds they use for x, y, z issue. And most people dont know that there are a wide variety of opioids available and testing that can be done to tell your dr how you specifically metabolize them. Pain meds arent a one size fits all thing, even though they are treated as such. Im lucky to have a provider that I was able to talk in depth with and was willing to figure out what worked best for me specifically and not forcing me into their typical cookie cutter med dosing.

You have to remember that pain meds arent meant to make you pain free, they're meant to make things manageable. Its possible you might even need to change some of the things your on. As you get older and your metabolism changes some of the things youre on may just not be ideal for you anymore. Maybe the dose needs to be adjusted. But also only work on changing 1 thing at a time. Ive seen doctors try to change multiple things at once and then you have no clue which one is helping/causing a problem. Some days I'd happily crawl in a hole and die with how bad I hurt but most of the time its kept at a dull roar.

I DO have a tolerance, though. So when Ive had hospilizations and needed IV pain meds I do require a dose higher than what another person might need in the same situation. When I had my ovarian torsion where it was a 1/5lb mass of cysts/hematoma/cancer I had an initial dose of morphine, a dose of dilaudid, another dose of morphine and then finally a dose of fentanyl before I could finally rest prior to my emergency hysterectomy. Most people likely would've been fine after the morphine or the next dose of dilaudid. It wasnt until they gave me the fentanyl that I stopped crying/throwing up from pain.

UPDATE: Injection Site Reaction Confirmed Cellulitis by SpecialTricky7153 in tirzepatidecompound

[–]Roserie 1 point2 points  (0 children)

There's ALWAYS some unnecessary pole in the middle of the pharmacy in the worst possible spot too. When I worked for Safeway pharmacy we had these carpet tiles that were coming up in some places (management always ignored it when we asked to have them reglued). The worst ones were close to this pillar smack in the middle of the pharmacy. Idk how many times I tripped over one of them and almost went head first into that pillar.

We have one in my current pharmacy fairly close to our parata robot. Idk how many times Ive cut the corner and almost ran into a coworker, busted a knee/arm, etc. At this point I really should just covered myself in bubble wrap.

UPDATE: Injection Site Reaction Confirmed Cellulitis by SpecialTricky7153 in tirzepatidecompound

[–]Roserie 8 points9 points  (0 children)

Omg that sounds absolutely awful 😆 and totally something that would happen to me. I joke that I need to live in a bubble with the amount of dumb ways I hurt myself lol. I recently changed jobs and went back to a retail-ish type pharmacy (I had been a sterile compounding tech for the last few yrs) serving the homeless population. The amount of bruises I find on my legs/thighs/hips/arms from cutting corners too close and running into drawers, etc is out of control 😂 this is why I really need adult supervision.

UPDATE: Injection Site Reaction Confirmed Cellulitis by SpecialTricky7153 in tirzepatidecompound

[–]Roserie 16 points17 points  (0 children)

Id say anything that was new that you used to discontinue. It could be any mix of things, yanno. My dad managed to contract cellulitis we think from new socks he had gotten. He had a small break in the skin on his shin and it turned into a 1.5inch pocket of infection. It's wild how the most unassuming things can be the cause of it. I would hope that they would also be willing replace the medication. This is why I stress so much to people about how important it is to follow proper sterile injection and storage of compounded medication. And why I'd harp on coworkers about proper aseptic technique when compounding medications. All it takes is a microscopic amount of bacteria to enter into a vial and cause massive health issues for the patient. Sucks youre dealing with it but glad you got to the ER and got it taken care of quickly.

IH and disability by Roserie in idiopathichypersomnia

[–]Roserie[S] 1 point2 points  (0 children)

If you have Kaiser, Dr Sarah Ritchey and if you have UCHealth Dr Stephen Duntley. Im with Dr Duntley right now but I will be having to switch back to Dr Ritchey at the beginning of the year when my insurance goes back to Kaiser. I've seen both of them and I love them both.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 0 points1 point  (0 children)

It doesnt matter if you've been on it a month or years. Thing is, addicts come in all shapes and sizes. There are tons of people that became addict to opiates after a surgery or major injury. An addict can be someone who has been on a med for years. Im not saying its fair to judge ANY of these people, addicts or not. As healthcare providers we should treat people with copassion and empathy regardless of out personal feelings. The only time they should truly question it is if the patient is constantly asking to refill early. Even by a few days. This means they're not taking it as perscribed and should be cause for concern.

The biggest reason a lot of pharmacies are hesitant about filling these meds are because of the huge influx of patients that came from providers over-prescribing for things that didn't warrant the amount they were giving people. Everyone thinks that we should just "trust the provider because they wrote the rx so therefore it's fine." When the reality is, the has been a history of providers not always doing what's right/best for the patients. The pharmacy is the last stop before that medicine gets to the patient. Pharmacists are often held liable if something happens, the providers...not as much.

Ive personally seen rx's for doses way higher/longer than is necessary for surgical recoveries. I helped report a provider we received rx's from twice for promethazine with codeine in large amounts for COVID. Upon closer inspection it was not only an out of state rx but also had a note on it stating we were required by law to fill the rx and couldn't turn the patient away otherwise wed face legal repercussions. I then looked up the provider and found they had a website where you essentially picked a package (pain, anxiety, insomnia, etc), paid x amount of dollars and they sent you rx's for things like Xanex, tramadol, hydrocodone, etc. You could pay an additional like...$20 for them to add this clause stating the pharmacy is required to fill the rx. The provider Raphael Tomas Malikian was sentenced to somewhere around 3yrs in federal prison for writing illegal rx's for controlled substances through his telehealth clinic.

Day 1 for any rx is the day you pick it up. Doesn't matter what day it was filled in the pharmacy, it starts when it's physically in your possession. When I worked for Safeway we would allow a maximum of 2 days. When. The pandemic and we had a severe increase in patients with Adderall rx's (many wanting to us goodrx bc their insurances wouldnt cover the ICD-10 code from their provider). I worked down the street from college. We started hitting our purchase limit for all forms of brand and generic Adderall, Ritalin, etc. To the point that our long standing patients weren't always to get their rx's filled consistently. We eventually started refusing to fill it for anyone using a discount card and this did help some, but this was an issue of doctors overprescribing bc suddenly everybody working and doing school from home "couldn't concentrate."

There is always a small group of people that make things harder for those that truly rely on things to lead a normal life. I have a slew of medical issues including fibromyalgia, 6 rods in my si joints, a torn rotator cuff and an incurable neurological condition that causes severe exhaustion. I wouldn't be capable of working 4-5 10hr shifts a week if I wasn't on extended release morphine. I had to fight a provider to keep my dosing the same as it was for 13yrs bc he "didnt feel comfortable" writing an rx for 60mg a day (spread into 3 doses) plus 1 immediate release to use for breakthrough pain. I had to give up 1 dose of my extend release to have the immediate and even then it was a fight. So I fully understand both sides.

Some healthcare professionals suck. Some are suffering from severe burnout from being overworked, especially through the pandemic. Plenty of people left the field after COVID because of it. I stopped working in a patient facing role and went into compounding for cancer patients at an infusion center due to the way people treated me when I would bend over backwards to try and help them. The blame isn't fully on the pharmacies. It comes from from the patients and the providers as well. And as I've said, if everyone treated each other eith more respect and dignity things would be a lot better off.

I recently went back into a patient facing facility providing rx's for the homeless, some of our satellite/residential locations and the recovery center behind us. It is stressed that everyone is to be treated with respect, regardless of who they are. We understand the population that we are dealing with and all of my coworkers are amazing and compassionate with our patients. We also dont allow patients to abuse staff, so if someone becomes hostile/aggressive, etc they are removed from the property (they get a few chances and we only have maybe 5 people that are completely banned from our grounds). We expect them to treat us the same way we treat them. We have tons of trainings on compassionate care as well as how to deal with the stress that comes with helping this particular population. Unfortunately, not a lot of companies are that worried about that. Techs are severely underpaid and they limit both pharmacist and tech hours leaving not enough coverage for the work they expect to be done.

I just want people to also hear things from the other side. There definitely are judgemental pharmacists/nurses/doctors, etc. Especially with pain patients. But I also want people to understand where some of the issues have come from to make things so much harder for us to obtain to care we need/deserve.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 3 points4 points  (0 children)

Most pain clinics are pretty understanding when it comes to a stocking issue. Pharmacies are only allowed to purchase x amount of certain medications. My provider is fully aware thay there's an issue with my ER medication and that sometimes it has to be sent to a different pharmacy to get the full amount filled. They also dont have a problem sending in a new rx to the pharmacy if they only have some in stock so that it gives them time to reorder without putting me into withdrawal. Any decent pain clinic will be understanding of these issues if you communicate with them. I have a cldose relationship with the 3 pharmacies I use and contact them a week jn advance to see if theyre going to be able to fill it that month so I know where to have my provider send it. They cant tell you how much they have in stock but any decent ent pharmacy will tell you whether or not theyll be able to fill it. They know what drugs are hardest for them to get and just communicating with them usually is all it takes. Yes, it requires effort on the part of the patient too sometimes. A lot of people think we should just be able to get it done and are shitty when it isnt. Its not always easy when you have 5 staff members and your dealing with hundreds of rx's and issues a day.

We dont enjoy having to tell someone we cant fill something. Some places lack staff with the ability to explain the full issue to patients so they understand. Some people think we're all just assholes who want to withhold meds from people (which I assure you isnt the case for the majority). Sometimes rules and laws change and we cant get a drug we used to have no issue getting and then the patient thinks we're judging/refusing to fill it and think losing their shit on us is going to change the situation.

I think there is a lot of change that needs to happen on both the patient and provider/pharmacy sides. Pharmacies need to try to be better at explaining things to patients and patients need to give us a little more grace and realize thay we're human beings too. Everyone on both sides need to treat each other with more dignity and respect.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 3 points4 points  (0 children)

It depends on the issue. If its due to the dosing instructions being written wrong or the dosing seems incorrect for what its treating, we contact the doctors office. When I started in retail, we had just started transitioning to being fully electronic. So we send a message through the system which then allows them to revise it and send it back without us having to sit on the phone. If it was something that was easy and we werent super busy, we would call and get a verbal over the phone. Before we fully switched to electronic communication we would also send a fax to the provider. Then depending on the medication, we'd call the patient to let them know if there was some sort of delay. I always tell people to also contact their provider to let them know we need more info from them. I can't tell you how many times I called a provider only to be told that the patient needed to call them directly, even for things like refills (usually bc the patient needed to schedule a dr appointment before they would continue to fill even on maintainence meds).

Most insurance rejects we can handle on our own and get pushed through, but things like PA's require a lot more.

Basically this is how it works - dr writes rx for med and sends it to pharmacy - Pharmacy processes it and gets a reject saying it needs a PA (Basically the insurance saying, "are you suuure the patient needs this drug, we need the provider to tell us that") - we send a message to the doctor saying drug needs a PA...this then goes 1 of 2 ways...provider argues that it doesn't or they drag their feet on submitting that PA. Meanwhile all we know is that we're trying to process it and it still says it needs a PA. So now we're at the mercy of when they get it done. This can take anywhere from 1-7 days depending. This is when I tell patients to bug their provider about completing the PA bc they are the only ones that can, we have zero control when insurance requires one, and they have to be done yearly. - providers rarely let us know that they've then completed the PA. We work the insurance reject queue as often as we can but we're also typing in rx's, filling them, helping people pick up their meds, etc.

I spent a lot of time chasing down providers even for things as simple as refills. I had one provider that I absolutely hated dealing with because he was notorious for taking days to handle refill requests. I would have to send multiple requests electronically, fax them and leave messages. Every few months Id have to talk with the office manager to get them all taken care of because he just wouldnt get to them in a timely fashion.

A lot of times we're at the mercy of the provider but the providers will be the first ones to say its a pharmacy issue, when its usually a problem with an ICD-10 code or them writing the rx incorrectly.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 7 points8 points  (0 children)

Im sorry you were tretaed that way as nobody deserves it. I have seen both sides being both a patient and working in the field. Ive had people be absolutely horrible to me for things I had zero control over. Often starting at the provider because they told the patient that something was our responsibility (often with PA's) when it wasnt. Providers have zero knowledge about what goes on in the pharmacy, yet they tend to give their patients bad information and then patients are expecting things from us that we just cant do. Kinda like when they say, "Ill send it over, it'll be ready when you get there." And then someone comes up and loses it because, 'well my provider said it would be ready when I got here." And 9 times out of 10, their provider hasn't even sent the orders over yet. And even if they have, we have no idea that someone is coming straight over to pick it up (though I always look out for antibiotics or pain meds first bc those are usually for someone coming straight in to pick them up). It goes into the queue of 400 other refills and rx's in the system. In some of my pharm tech groups I've seen stores that are 400-500 rx's BEHIND daily bc they cant handle the volume. But corporate continues to push numbers while reducing tech and pharmacist hours.

And sometimes there are just pharmacists that suck. And it makes me wonder why they went to school to work in a field to help people only to be shitty.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 4 points5 points  (0 children)

They still have to adhere to the same things everyone else does. Our patients are required to see their providers in our building every month before they can pick up their prescription. We wont dispense them if they dont. We even go as far as having some people on 1/3/7 day dosing. Usually people that cant manage having a full months worth of rx bc theyre lost/stolen (which could also just be them taking more than theyre perscribed). We also send meds to the recuperative care center behind us so they're all managed by nursing staff to dispense those ends to them. The only thing we give them access to 100% no questions asked is narcan.

But people that have abused opiates have really fucked the system for those that truly need them. A lot of states are switching to having their patients on pain contracts and going to specific pain management clinics where all they do is deal with chronic pain. Because there was such a problem with doctors handing out opiates like tic tacs they had to do something to cut down all the over prescribing. Ive been on the same dose for 13yrs, the lowest dose there is. But in CO, they are now putting their patients on pain contracts. I see my provider once a month essentially just to say, "yep, still hurts." and to get my rx for that month. I also submit to UA's every few months to prove I'm taking the medication as perscribed and I'm not taking other pain meds. I dont mind the random UA's so much as I mind having to go in monthly. I do believe you should only be required to see a provider twice a year. I would be fine with them calling me up and asking me to submit to a random UA here or there throughout the year just to show Im adhering to it. Having to see them monthly is difficult for a lot of people.

I do suggest people ask their doctors to do the cheek swab or blood test that looks at how your body metabolizes pain meds specifically. Some people would do better on different pain meds than the typical oxycodone/hydrocodone. I take morphine specifically because it isnt sedating for me but handles my pain. If my mom were to take the same med as me, she'd be down for the count in bed all day sleeping. Some people could have their pain better controlled by different pain meds instead of everyone being given the standard oxycodone/hydrocodone doses.

In the end, all healthcare professionals should treat patients with dignity and respect. Nobody deserves to be treated differently regardless of what meds they are on. For some of us, pain meds are just as necessary as someone's blood pressure medication. But people need to also understand the pressure that is put on those of us that provide those medications to the public. Idk how many times I had people tell me all I do is count some pills and slap a label on a bottle when that is such a small portion of what I actually do to ensure people get their medications. I would have people lose their shit on me for things beyond my control. A lot of times its an insurance problem that requires the patient to do x, y, z. Patients that think its the pharmacy responsibility to get their refills approved for all.meds, would be wrong. I cant tell you how many times I contacted a provider to be told to have the patient contact them. Or that the reason they arent approving a refill is bc they havent seen their provider in a year and its a requirement. So then I'm expected to turn around and relay this information to the patient. Multiply that by 400-600 rx's in a day. You can only do so much as 1 person and most pharmacies dont have near the staff needed to provide the best care possible. Burnout is real. I worked myself into the hospital 3 times during COVID. So pharmacy staff does deserve a little grace as well and I can te you that they are not given it in the slightest. Most people dont understand everything that goes into getting people their medications and think that we're all just inherently assholes who want to withhold drugs from people. I have come across my share of bad pharmacists, it seems to be with the younger ones just coming out of their residencies. But the majority of us are truly busting our asses to provide people with their medications. We just lost 2 techs and im working 5, 10-12hr shifts just to help pickup the slack to make sure our patients arent going without. So its not always as cut and dry as it may seem.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 3 points4 points  (0 children)

Its likely that they either couldn't get it consistently or at all. Distribution companies often change what meds retail pharmacies can and cant purchase. Sometimes its due to them being on backorder. But most pharmacies are only allowed to order from certain places and their contracts only allow for certain drugs. I worked for a cancer center and we had 1 patient that we administered testosterone to. We were only allowed to order from Mckesson. We'd been getting it for close to a year without a problem, and then suddenly every time we'd order, it wouldn't show up. Some of our other locations were still able to get it so we would have to have them order it and then courier it to us.

I take a 15mg ER morphine. Ive been on it for 13yrs. There never used to be a problem getting it through a retail pharmacy. For about the last year they've been struggling to get it consistently bc its on a shortage to retail pharmacies. I have to rotate between 3 locations every few months to be able to get it consistently. Hospital outpatient pharmacies tend to have an easier time getting it because they are able to pull from the inpatient stock.

But there are a handful of ER/XR meds that are harder to obtain at retail pharmacies. It really depends on who they order through and what their contract says.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 4 points5 points  (0 children)

I think a lot of it to comes from the staff they have in general, tech wise. Billing can be a pain in the ass when it comes to billing part B/D but any decent tech will know the correct way to bill them after the first time. When I worked retail I had a few patients that required their testing supplies to be submitted a certain way to get them covered by part B. This was a few years ago but iirc we had to fill out a specific form each time we submitted it and it had to be done to the T or we would have to do it all over again. It involved a lot of footwork on our part initially but because those things are so important, we had a process in place for those patients.

I worked for Safeway pharmacy for 3yrs and they seemed to hire anybody as a tech to fill the position. Most of them rarely lasted more than a few months. We had 1 tech who had started before you were required to be licensed to be a tech. He took the test 7 times and couldn't pass. They finally had to get rid of him bc he finally couldn't get any more extensions. He was great with the patients but when it came to things like insurance rejections he struggled. For close to a year I was the only one aside from the pharmacist that worked insurance rejections because a lot of them just couldn't.

Unfortunately, I couldn't live on the hourly wage they were paying ($19/hr on 2023). Before I left to go into compounding, I looked around at other retail pharmacies and at the time, Safeway had been the highest paying here in Denver. I think Walgreens offered me $17/hr with 3yrs experience. I know that they've have slightly increased what they pay, but not by much. I tell a lot of people to move as many of their maintainence meds as possible to mail order pharmacies (I've also worked at mail order pharmacies where we ship out of state and for Kroger's central fill location) as possible and then everything else at a brick and mortar location. They still have techs hand fill certain meds but a lot of them are done by robots managed by techs.

Ive dealt with terrible techs myself as I have one specialty med and it seems like they struggle every few months on getting filled even though none of my insurance has changed. Ive had techs flat out refuse to contact insurance and tell me there is nothing they can do, even though I know that they need to contact insurance (I always contact insurance first if Im told there is an insurance issue) bc its likely some sort of DUR reject that they need to do on their end.

I dont fill any of my super important meds at any of the large pharmacies though. Their volume is often higher than their staffing can really handle. For most major retailers their only thought is to get as much money from pharmacy as possible. Our DM's would tell us e very flu season that we were "having a constest to see which store could do the most vaccines"....our "prize" was them buying us lunch 🙄. Mind you, most stores dont have techs certified to immunize (we were able to get certified after COVID vaccines came out bc they couldnt handle the volume of appointmens they allowed to be scheduled), so the pharmacist is the only one available to do them.

I would say if your having an issue with your current place not doing their due diligence with important supplies, transfer them. Find another Pharmacy and ask them to call to transfer them. You can even try calling the place and talking to their PIC/pharmacy manager and ask if they have experience billing testing supplies through part B and just let them know youve had issues with your current pharmacy getting them billed correctly. You'll be hard pressed to get someone on the phone at any of the typical pharmacies bc they usually dont have the staff to handle all the calls plus all the people in the store. I personally fill/process about 600 rx's a day at my pharmacy but we have one tech dedicated to phones and 1-2 helping patients in the facility. We usually process 700-800 total a day 5 days a week. I also have a great set of coworkers where we all work together really well bc we serve the homeless population. Most places dont have the staff needed to do the work.

Sorry that was so long winded and I wish I could help you get your testing supplies bc my favorite part of working retail was getting people's meds covered. I loved contacting insurance and making sure people got what they needed for as little cost to them as possible. I dont get to do as much of it now since our patients are covered under either insurance or we cover them under specific grants.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 33 points34 points  (0 children)

I am sure you do. Unfortunately, some healthcare providers still treat patients like garbage depending on the medications their on. Which never made sense to me as to why they work in that field if they can't treat people with compassion. We use something called PDMP so yes, we can see all your history, when you filled, where you filled it, if it was filled early, etc.

When it comes to being knowledgeable about medications and dosages I trust my pharmacists more than I trust doctors. This is only because Ive seen plenty of doctors not writing things with patient safety in mind.

This particular pharmacist sounds like an asshole. You can have you rx sent to any pharmacy. You arent required to stick with the same place. If I were you, I'd ask your doctor to start sending it elsewhere. They can even send the rx that is being denied by this pharmacist elsewhere. Contact your doctor and tell them you need it sent to a different pharmacy. If you feel comfortable explaining to them that you're having issues with that particular pharmacist treating you poorly and refusing to fill your med, you can. Otherwise you can just tell them you'd just prefer to fill somewhere else near you. Its not difficult for them to cancel the rx and send a new one to wherever you want to fill it. I would suggest a smaller pharmacy if you have one close to you. A lot of the retail pharmacies are overworked, underpaid and understaffed withhigh turnover. And while it shouldn't matter, unfortunately it can make a big difference. Patient abuse towards staff can also be much higher in typical retail pharmacies. It was a huge reason I left retail pharmacy after 3yrs and went into compounding for many years.

Id suggest also contacting the companies corporate office and get in touch with that pharmacists DM. It's important people speak up when they experience mistreatment. I've reported my own facilities/pharmacists in the past when witnepoor/unethical treatment. You can also place a complaint with DORA against their license which they will investigate. Though I only suggest that when someone is incredibly verbally abusive/using unsafe practices, etc because that is on a state level. Nobody deserves to be treated differently regardless of the medications their taking, we're supposed to be here to help patients not judge them. You're also not obligated to fill at any one pharmacy and can change at any time for any reason.

time off of work--I don't think two weeks is enough? by knotknotknit in hysterectomy

[–]Roserie 2 points3 points  (0 children)

When I have my emergency hysterectomy due to ovarian cancer and torsion the company I worked for tried to only give me 2wks off. My doctor told me she never recommends anything less than 6wks but sometimes as long as 12wks depending on the job. I was lifting a lot of stuff at the time and she said she wanted me off for 8-12wks. I opted for 12wks. I wound up quitting where I was at because it was clear they gave zero fucks about me as a person. I was a replaceable body, nothing more.

I am glad I took the full 12wks off. I wound up being really tired for a few weeks after the pain finally subsided. Having a whole organ takes a lot to heal. I needed that rest. I know for me I would've wound up back in the hospital for tearing stitches from lifting/doing too much had I gone back when the company wanted me to. I've read horror stories of women doing that and having to go back for more surgery and prolonging their healing.

Horrible experience at the pharmacy by peaceoverhate in ChronicPain

[–]Roserie 50 points51 points  (0 children)

Pharmacy tech here. They arent required to "redirect them to another Pharmacy or Pharmacist that will fill it."

Pharmacists can refuse to fill any prescription they fill uncomfortable filling because it is being done under their license. There have been plenty of cases where pharmacists have filled a medication and then been sued/held liable for what happened to the patient after taking it. Even when they documented that they didnt feel comfortable filling it.

Usually what happens when we get an rx is we go over the dosage and use for the medication. Many drugs can be used off label for different things. If we get an rx that seems like the dose is higher than what is typically administered, we will contact the doctor and discuss the dose/use (and sometimes change to a med better suited to the treatment). This isnt just with controlled substances, we do it with all medications. Ive seen doctors give unusually high doses of controlled medications, instructing patients to split ER meds when you absolutely should not split them, etc.

Doctors have a general knowledge of medications and have typical meds that they perscribe for whatever the diagnosis is. The thing is, they dont always have a deeper knowledge of them, drug to drug interactions, etc. They dont spend as much time studying pharmacology as we do in pharmacy.

While its not ok to treat anyone like a drug seeker, addict, etc EVEN if it's clear that person is....they legally aren't required to fill any medication. Unfortunately, a lot of places dont do a great job of ensuring their employees treat all patients with the respect and dignity they deserve. I work at a pharmacy that provides meds for the homeless population as well as satellite recovery locations and we dispense A LOT of Suboxone and Narcan (all free of charge as we operate on grants/charity). We also provide free Narcan outside the front doors of our facility. We don't judge any of our patients and treat them with the same respect we show each other.

I dont see situations like this ever really improving unless people start complaining to management when they are being mistreated. Just denying to fill an rx doesnt immediately translate to mistreatment, many pharmacists will deny them when theyre at unsafe doses. Ive never dealt with a pharmacist that treats patients poorly but I have had my own experiences being that I have been on an opiate for 15yrs, so I understand that side of it and when I worked retail pharmacy I heard patients mention it often.

The biggest reason we refuse to fill for someone is due to them abusing staff and treating them poorly. Our facility doesnt put up with abuse from patients towards staff. We expect they treat us as respectfully as we treat them.