So, i just had a frustrating encounter with the pharmacy that i have been using for the past 2 years. I'm about ready to switch. Let's see if i can explain this without posting my dose, since i know that isn't allowed.....
Each vial i get is supposed to last me two months (four doses - i dose bi-weekly). I'm on the last dose in this current vial, but I know i wasted a little bit more than usual (i still get shaking when drawing - not a fan of needles but getting better) two weeks ago and eyeballing it i'm not sure i have a full dose left. So i called my doctor, who more or less said they would call in my script "just in case". Okay. Cool. I hear nothing from the pharmacy, though, for like three days, so i go in and ask.
I was basically told that because i got the last vial less than two months ago, they won't fill it. Okay, fine, i guess they can't fill it if i've still technically got a dose left in the vial? I mention that i wasn't sure i had enough for my Wednesday dose, because eyeballing it... that's what it looks to me. The guy got really huffy and basically started accusing me of not drawing it right, that i SHOULD have enough because that's what in the vial, etc etc.
I got a little bit defensive, because hello - i'm still relatively new at this. I'm not dosing too high, and i'm not wasting a ton trying to get the draw right. Like i said, i still get shaky when i draw because i'm not big on needles. That i can do this at all is huge for me. So some wastage might happen.
He basically said that he won't fill it until the 20th, that i should have enough, etc, and got really rude about it. Like, stomping feet and slamming things on the counter rude. So i left. Fine. I'll just use what i have. But I just checked my log book, because i DO keep track of my injections - he made me feel like I did something wrong somewhere so i had to look. Nope. Everything is on track. Right doses at the right times. I must have just wasted a bit more than usual the last time, like i thought. But taking another look i realize that after this weeks dose, my NEXT dose is FOUR DAYS before the guy said he would refill my script.
I'm hesitant to go back in there, even in another week or two.
Any suggestions on how to pick a pharmacy whose pharmacist isn't a jerk? I don't think i was in the wrong...? And i'm a little bit confused. The vial is exactly enough for four doses but what if there is an oops and i waste some? Am i not allowed to get it refilled "early" if that happens, so i have to low dose or miss a dose? It doesn't make sense to me, though i understand them not wanting to fill the scripts too often.... but then i hear about guys "stockpiling" their T or having "extra" for "just in case" and i get confused again, because this guy DEFINITELY won't let that happen in his pharmacy. Made it sound like a national offense or something.
Is it something i have to ask the endo about? Thankfully, i see him on the 16th. I will definitely be bringing it up. But any other suggestions from you guys would be very welcome. I'm pretty frustrated. I work in retail (sort of) so i know how frustrating some clients can be, but even if i was a bit snotty to him (and i admit i was a little bit) the way he first reacted and continued to act was just...... I don't know. I feel kinda bad, but at the same time i'm just ticked off.
Unfortunately often we end up knowing more than some of the people providing our medical care. In this case you should discuss this with your endo. Your endo can instruct the pharmacist to provide additional medication or provide you with a spare should you need it in the future. It's also possible your endo can suggest another place to get your medications. After your levels are are at the proper level, you time between appointments will be long enough that this shouldn't be a problem. I run about a month reserve on my pills by setting my appointment date a little earlier thus giving me a safety margin.
Quote from: TK9NY on January 01, 2018, 08:12:21 PM
and got really rude about it. Like, stomping feet and slamming things on the counter rude.
When you say "Like stomping feet..." is this a actual or similar actions?
Did the Pharmacist really do these things?
This behavior is definitely unacceptable by anyone standards.
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So i left.
Best option with dealing with unreasonable people. Further discussion is not productive.
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Any suggestions on how to pick a pharmacy whose pharmacist isn't a jerk?
I am a retired Pharmacist and I hate to say this but I have seen a few too many Pharmacists act like jerks on occasion. Almost all the time, Pharmacists are understanding and helpful to their patients. Jerks are the exception, but they are in all professions. They do not last very long in their present position.
The main problem here is insurance. Will your insurance pay for an early refill? Also, Testosterone is a controlled drug and is subject to strict penalties for the Pharmacist if there is any deviation from Federal controlled drug laws. This is serious. I know a few Pharmacists who were sent to prison in a Federal Penitentiary for years for incorrect filling of controlled drugs.
Without knowing the specifics of you situation, I would say that having a little extra on hand is within the guidelines of legitimate medical practice. Also, many prescription insurance plans allow for an extra amount to be filled early. We call the insurance company for a "vacation overide" if they delay filling because it is too early.
Quote from: Dani on January 02, 2018, 06:15:01 AM
When you say "Like stomping feet..." is this a actual or similar actions?
Did the Pharmacist really do these things?
This behavior is definitely unacceptable by anyone standards.
He didn't actually stomp his feet, but he did get very short and rude with me and at one point when he was handling other prescriptions as he spoke with me he slammed them down on the counter. The whole vibe i was getting was "child throwing a hissy fit" and i just felt like he was being very judgmental and not at all helpful when i felt i had legit questions for him.
Quote from: Dani on January 02, 2018, 06:15:01 AM
The main problem here is insurance. Will your insurance pay for an early refill? Also, Testosterone is a controlled drug and is subject to strict penalties for the Pharmacist if there is any deviation from Federal controlled drug laws. This is serious. I know a few Pharmacists who were sent to prison in a Federal Penitentiary for years for incorrect filling of controlled drugs.
Without knowing the specifics of you situation, I would say that having a little extra on hand is within the guidelines of legitimate medical practice. Also, many prescription insurance plans allow for an extra amount to be filled early. We call the insurance company for a "vacation overide" if they delay filling because it is too early.
I pay for my T out of pocket, so insurance isn't the issue.
I think his concern was legal, sure, and i totally understand that. But i'm still stung over the fact that he was rude about the whole thing. I legit just wanted to know what my options where if i didn't have enough for a full dose and he made it seem like i was the one at fault for that and that he couldn't do anything about it. If he had said that his hands where tied legally, and to call my endo instead for suggestions, i would have left with no issue - but he instead made it seem like i did something wrong and even mentioned "making exceptions" before more or less saying "you should have enough, i don't know why you don't, so no."
He's there to answer these kinds of questions, am i right? I don't remember ever having a pharmacists talk to me, or even my parents, like this guy did to me. I wasn't being unreasonable, was i? He made me feel like i was, and i still kinda wonder if i was in the wrong somehow even though i don't THINK i was... ugh, i don't do well with confrontation!!!
I'm still curious, though - he said i should have enough in one vial for four doses. Okay. I did the math and he's technically right. There is exactly enough in one vial for four exact doses. But that doesn't account for whatever is left in the needle (i assume there is some left each time you inject) or the little that gets wasted when you prep. So theoretically by the time i'm at the last dose in the vial, it isn't going to be enough for a full fourth dose. Am i right?! Not a lot of room for "oops", even a tiny "oops". So i DON'T think it's unreasonable to want a refill "just in case" as i'm on the final dose in the vial. Two doses left, sure, unreasonable, or a full vial.... but "i don't think i have enough for the last dose to be a full one"?
I think i'm just going to try another pharmacist and when i go in on the 16th for my check up i'll mention this to the endo and see if he can't prescribe a slightly bigger vial or something. It's probable that my dose will increase, so i might need a new size/script anyway. In the mean time i'll just do my shot tomorrow and make note of how much i was able to draw/inject - if it's super low then i'll call the endo directly about it and just not deal with the pharmacist.... i don't feel like going back in there again.
i've actually had this happen to me with a pharmacist. i ran out, i guess i must have taken a bit too much on a few doses and i ran out faster then i should have. i've had the pharmacist tell me they can't fill it until a certain date. it's only happened once. the pharmacist didn't get short with me just told me that they can't fill it because it should last me say a month, and if i go in a week earlier, they can't fill it. i think the prescription even says when they can refill it. either way if you don't like how it was filled out, then just go to another pharmacy.
Ask your doc to prescribe a larger vial. The 10 ml vial should contain plenty of doses so you do not have to worry about having enough. I experienced this problem while I was living in another state and had to get my prescription filled via mail order pharmacy since every pharmacy in that state only dispensed 1ml vials!!!!
The CDC's "One and Only Campaign" in addition to the 28-30 days after first puncture rule (that's suddenly cropped up) is why 10mL vials are no longer dispensed. It's a colossal mess. Nobody knows what in the hell is really going on. All I can say, I've never once had an infection due to an MDR vial (and I'd used each of mine over the course of 8 months, and for longer than 4 years).
1mL vials are what you can get dispensed now (though compounding pharmacies MAY still be an exception). They are single-dose (SDV), as in if your prescribing doctor and/or pharmacist and/or insurance are setting you up to have to use that single-dose vial for multi-dose use they are doing you a grave disservice (and potentially opening themselves up to a malpractice suit). They are meant to be used for ONE dose, whether or not there are leftovers after your ONE dose amount. This is actually for legitimate health and safety concerns, as these SDV vials are NOT made the same as MDR vials (antimicrobial factors).
And, yes, there is quite a bit more wastage involved with these tiny 1mL vials than the 10mL vials. Both because they are smaller and you need to use more of them than one 10mL (it is physically impossible to extract every last drop from the neck. Ergo, more vials used over the same duration as precious single and larger vial = more wastage), and also due to the usual 0.1-0.2mL or so left in the syringe. I was being shortchanged an entire dose a month before I managed to get it mostly sorted out (my dose at that time was the precise amount of 1/4th of a 1mL vial. It was physically impossible to make that work).
Of course, 1mL vials are also considerably more expensive than a 10mL vial. What used to be about $100 out of pocket for one 10mL vial is now about $300 for ten 1mL vials! And it's even yet more expensive than that for also having to make more appointments to secure more refills, more drive-backs to correct script errors (in my case EVERY time; can't get them to do anything over the phone or fax so I have to go there in person), and yet further commute costs to go fetch it every 3-4 months instead of 8 months too. It's absurd and extremely inconvenient, but there it is. And big gub'mint don't care, not their problem.
Anyway, you must deal with this with your prescribing physician. Nobody else can fix it. You need to explain in exacting detail (I mean that most literally) what the issues are and have them write your prescription out effective that you are using a new 1mL vial for every dose (again, these vials are for SINGLE-DOSE USE ONLY). This also should more or less resolve your increased wastage loss problem. I will reiterate, for how ever many doses you are to take between your appointments, you need that many 1mL vials in your prescription (by refills if necessary. I believe you can now only get 3-months worth dispensed at any one time. And that is calculated based on your dose amount).