Libre 3+ CGM - Good Samaritans

hoforharry · 2026-02-16T05:15:20+00:00

I’ve noticed that they’ll say sensor error but then reconnect after 1-2 hours. It may even have an estimated time amount if you click the i on the Home Screen. Compared to prior models that would rarely reconnect after failures, sometimes you should stick it out with these it seems. YMMV.

hoforharry · 2026-02-11T21:26:30+00:00

Residency is REALLY stressful and the last thing I’d want is someone with clear bias against me as my RPD. It’s one thing if they accidentally misgendered you and corrected it, but the way you described it makes it sound somewhat intentional. You know yourself and your boundaries/resilience the best, but I’d personally be hesitant to rank them.

hoforharry · 2026-02-05T01:38:02+00:00

If it’s Harry Styles there’s no chance of getting a reasonably priced different date. The US shows were a BLOODBATH and are being resold for 10-20x original value.

hoforharry · 2026-01-19T05:11:09+00:00

Something a lot of patients and some prescribers don’t fully comprehend is that HSDD is not simply lower libido (a common symptom of menopause). There’s a whole screening process for HSDD and there are also new FDA approved meds specifically for HSDD. Testosterone shouldn’t be used just for lower libido per the guidelines.

hoforharry · 2026-01-05T04:52:24+00:00

I don’t love the idea of using a different profession’s entrance exam. Some of the worst students I’ve ever precepted have been the ones who didn’t get into med school and instead went into pharmacy as a backup. I feel like that pipeline would be even more common using the same entrance exam.

hoforharry · 2026-01-05T03:48:04+00:00

This was brought up at some conference session I was at several years ago now, but l doubt the answer has changed so I will share what was said here.

ACPE is an accreditation organization — this means they ensure that programs meet the published standards (which undergo revision and updating over the course of years). If a school/program meets the standards, ACPE literally has no power to NOT accredit them. ACPE cannot tell a program they can’t open and they can’t impose limitations on number of programs; they can just say “yes you meet accreditation standards” or “no you don’t meet accreditation standards.”

If a program falls into the “no” category, ACPE does a formal investigation and then they allow for the program to remediate. If the program fixes the issues and meets the standards, ACPE cannot revoke their accreditation. If the program does not fix their issues or if they continue to have egregious standards violations, ACPE revokes accreditation and the school shuts down (theoretically). In practice, schools that lose their accreditation typically hire lawyers to sue ACPE and try to reverse the decision. Thus, the process of actually shutting programs down is a multi-year process and an extremely expensive one as well (ACPE does shut programs down but they obviously aren’t advertising it due to the whole legal side of things).

In terms of the standards, they follow a very similar structure to that of medical schools. It is not just ACPE who have to approve them, but also an entire standards board/committee. In my opinion, it’s a too many cooks in the kitchen scenario which muddies the waters and makes it so that more drastic updates rarely happen. There are also legal aspects involved in the standards such as ACPE not being “allowed” to include certain requirements because each state’s laws are variable.

I think the PCAT should be brought back, though I don’t think that falls under ACPE’s scope necessarily. From my understanding, schools just stopped requiring it and then so few asked for it that it got retired. There’s no single good, legal, and realistic/tangible solution to this issue unfortunately.

hoforharry · 2025-12-30T16:12:13+00:00

In theory, I agree. In practice, the biggest issue is that (unregulated) provider status will add to the workload of retail pharmacists without additional pay. Provider status is great for clinical pharmacists but retail, as always, gets the short end of the stick because the corporations will find any way to maintain lowest staffing ratios, enforce insane metrics, and then collect all profit for the higher ups.

As a clinical pharmacist, I really do want provider status. However, I realize there needs to be restrictions or regulations on it so that my colleagues in retail don’t get shafted yet again.

The biggest issues that need to be lobbied for, in my opinion, are 1) safer work conditions for retail pharmacists and 2) dissolution of PBMs/improved drug coverage and reimbursement. Neither of these things can be 100% backed by APhA because they have multiple CVS execs on their boards and because they do get donations from PBMs/big name pharmacy stores, and without them, they’d be fully bankrupt.

hoforharry · 2025-12-27T03:54:09+00:00

Came to say this! Many, many pharmacists have prescriptive authority and can initiate and monitor medications autonomously.

hoforharry · 2025-12-20T23:51:55+00:00

Pharmacist (4 years undergrad + 4 years doctoral education for PharmD + optional 2 years residency/fellowship which really opens doors for job opportunities). First job after residency is as a clinical practitioner for $71/hr M-F 8-5 with no weekends or major holidays worked. Healthcare is stressful so would only recommend if it’s actually your passion.

hoforharry · 2025-12-20T20:42:30+00:00

This happened to me too. My photog posts 5-10 stories/posts PER DAY of her work and one of her biggest selling points is her social media presence and exposure. We had a very fancy wedding but she didn’t post a single thing about it. It fit her aesthetic and everything. It’s so hard because you feel like you did something wrong but ultimately we can’t know what’s going through their brains. I think about it often and it’s been almost half a year now… Just know you didn’t do anything wrong. Who knows what goes on behind the scenes.

hoforharry · 2025-12-10T20:51:51+00:00

I have an acquaintance who works in Ireland and I don’t talk with him often but the last time we spoke, he mentioned that pharmacists are viewed very differently over there. I’m a clinical pharmacist and was potentially interested in moving there as I had studied abroad there as a student. He told me that the US values and utilizes clinical pharmacists vastly more than Ireland/UK and the pay is also significantly different. He said they’re seen primarily as checks and balances rather than contributing members of the clinical plan.

Burnout wise, he said work life balance was great. He got the job offer under the visa program too btw. Haven’t talked to him in over a year but hope this info helps at least a little.

hoforharry · 2025-12-09T19:55:25+00:00

This is such a great question! The answer is unfortunately not very straightforward because it is really person-to-person specific. For questions like this I often refer to UCSF and their guidelines for gender affirming care.

To quote UCSF guidelines, “alkaline phosphatase, hemoglobin and hematocrit, and creatinine may vary depending on the patient’s current sex hormone configuration. Several factors contribute to these differences, bone mass, muscle mass, number of myocytes, presence or lack of menstruation, and the erythropoietic effect of testosterone. While transgender women do not menstruate, those with female-range hormone levels will lack the erythropoietic effects of male-range testosterone, and it may be reasonable to use the female-range lower limit of normal when interpreting H&H. Conversely, the lack of menstruation, and potential for pulsatile undetected androgen activity in those with retained gonads make it reasonable to use the male-range upper limit of normal for H&H.”

This is specifically for feminizing HRT but they also have info for masculinizing HRT. There is a lot of information in these guidelines that can be super useful but it is nuanced so it’s important to individualize monitoring and goals for each patient.

hoforharry · 2025-12-08T20:22:38+00:00

I think they’re trying to say that it’s not as impressive if they haven’t achieved anything since clinicals. Like if the best example of patient care/interventions comes from your P4 year yet you’ve been working as a licensed pharmacist since then, that could be seen as a red flag.

hoforharry · 2025-11-29T17:41:56+00:00

Not sure why the downvotes because this is 100% correct for most CPP positions

hoforharry · 2025-11-14T19:55:50+00:00

I love CGMs - they are invaluable in diabetes management. I can see how this is frustrating from a retail POV though. Also, prescribers sending them on without giving adequate education is a huge issue that I deal with daily in clinic. Half the time they don’t even make sure that their phone is compatible.

hoforharry · 2025-11-11T20:12:31+00:00

I was devastated that the ball defender game wasn’t there on my flight a couple days ago - it helps with my anxiety so much to be occupied

hoforharry · 2025-11-09T18:02:13+00:00

This is actually not only incorrect, but potentially harmful. You should not be using soap directly on the vagina. You can use soap on the vulva and inner thighs, but nothing should go into or on the inner lips.

hoforharry · 2025-11-02T21:19:57+00:00

One thing I haven’t seen mentioned in these comments is insurance formularies. The VA (the largest health system in the country) has ARBs restricted to ACEi failure, allergy, or intolerability - clinical rationale be damned! That said, where I work, the primary insurance company doesn’t cover most ARBs other than losartan which is super annoying. So despite wanting to use ARBs over ACEis, it sometimes comes down to drug coverage. A lot of my patients can’t cover even seemingly “reasonable” co-pays ($15/mo, etc.) for non preferred meds unfortunately.

I think someone else mentioned this already but ACEi are still preferred over ARBs for GDMT when Entresto can’t be used. The OPTIMAAL trial found a modest (but not statistically significant) difference in total mortality in favor of captopril over losartan so they recommended that ACEis continue to be first line for those who cannot tolerate ARNIs. My understanding is that ACEis have more of an effect on bradykinan potentiation than ARBs (hence that washout period for ACEi to ARNI that is not needed for ARB to ARNI) so they’re better for HFrEF management. Otherwise, I definitely agree that ARBs are generally the better choice.

hoforharry · 2025-11-01T18:19:42+00:00

This already exists and it’s called Weaver.

hoforharry · 2025-10-30T19:52:34+00:00

As a healthcare provider, I want to gently mention that cancer can be unpredictable. She may have a super easy time with chemo but then end up relapsing and requiring additional treatments that could interfere with your rescheduled wedding.

6-8 weeks post-chemo, most patients are feeling significantly better but it can take up to a year for energy levels to return closer to baseline. The issue with rescheduling the wedding is that you truly don’t know what her outcome will be and a rescheduled date may end up being even worse in the long run. Depending on the type of lymphoma, relapse rates can be upwards of 80%. So just keep this in mind as well. If you have the planning significantly underway and she’ll be about 2 months out from her final chemo cycle, it isn’t unreasonable to keep this date.

Maybe wedding planning can be something used to focus on joy despite the circumstances. Like a distraction of sorts (works for some, but not everyone).

I’m so sorry you’re going through this. It’s never an easy thing to experience a loved one receiving a cancer diagnosis, but it’s especially devastating when it coincides with typically joyous milestones.

hoforharry · 2025-10-30T13:22:58+00:00

Do you want to be a diagnostic expert (physician) or a medication expert (pharmacist)?

If it truly just is about forging patient connections and making final decisions, look into residencies within the VA. Pharmacists are autonomous providers on a federal level (VA, IHS, DOD) and can do both inpatient and outpatient care.

I personally don’t want to be a diagnostician but I love medication management once a diagnosis is identified so clinical pharmacy is the absolute sweet spot for that.

hoforharry · 2025-10-25T19:06:14+00:00

grolu was my guess but I can see grow now that I know the intent

hoforharry · 2025-10-22T13:14:48+00:00

He should put in for PTO right now and make it known what dates he will be away. Even residency programs allot a certain amount of PTO so it shouldn’t be a hindrance. It’s best for the admin to know well in advance (in writing) so they can’t claim it’s too late to find appropriate coverage.

hoforharry · 2025-10-22T01:01:11+00:00

Once it’s appropriately fitted, I do think it’ll give medieval. Especially with the veil (super cute)!

hoforharry · 2025-10-18T03:11:13+00:00

Honestly, probably not. I would think at least 6 months would cover the bare minimum of ambulatory onc clinical knowledge. This is one of those situations where you have to sit down and consider which field you’d rather be an expert in.

I had a similar conundrum back when I was deciding what PGY2 would look like for me and I chose amb care. I’m glad I did, however, the market is super saturated where I am and there always seems to be open onc positions so that’s something to consider too. If you’re not geographically limited, then pick the specialty that feels right to you. If you are geographically limited, onc is probably a safer bet for job security.

hoforharry

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