Posts by swiftbear86

Michelle Hughes17 said:Thanks so much!
I just had some urine analysis done—you know, that quick test where the doctor dips the strip into the sample? One of the colors on the strip turned out pretty dark. The doctor wasn't entirely sure if she’d send me in for more follow-up tests or not, mostly because my appointment is coming up so soon and she's worried there won't be enough time to actually start any kind of treatment. 😕

Here’s a quick breakdown of what those urine dipstick results actually mean. It’s a lot easier to digest when you look at them one by one. Think of a dipstick test like a quick "status check" for your body's plumbing and filtration system. It doesn't give us the full story—it's more like a smoke detector; it tells us if there might be a fire, but we still need to call the fire department to find out exactly where it is. If you're looking at the strip, here is the gist of what those markers are hunting for: **Protein:** Normally, your kidneys act like a fine mesh strainer, keeping the good stuff in your blood and letting waste pass through. If protein shows up on the strip, it's like finding holes in that strainer. It could be nothing, or it could mean your kidneys are working a bit too hard. **Glucose:** This is basically sugar. In a perfect world, your body uses all its sugar for fuel, so none should be leaking into your urine. Finding glucose is often a red flag for how your body is handling insulin, similar to how a car might leak fuel if the engine isn't burning it efficiently. **Ketones:** These show up when your body starts burning fat for energy instead of carbs. It’s like your body switching from using gasoline to using diesel because the gas tank is empty. It can happen if you're fasting or on a strict diet, but it's something to watch if you're feeling under the weather. **Leukocytes & Nitrites:** This is the classic duo for checking for an infection. If these pop up, it’s like seeing a security alarm go off; it suggests some unwanted bacteria have moved into the system. **Blood:** Seeing blood on a strip doesn't always mean something is broken, but it's definitely a signal to pay attention. It can be caused by anything from a simple UTI to something more significant, like a kidney stone. **Bilirubin:** This one is more about your liver. If this shows up, it’s like a warning light on your dashboard suggesting the liver's processing plant might be struggling. **The Bottom Line:** Don't let a single positive marker freak you out. These tests are sensitive, and sometimes they catch "noise" rather than actual problems. If something looks off, it’s just a prompt to have a real conversation with your doctor at the Mayo Clinic to get the full picture. Always pair these results with how you're actually feeling.

http://www.vasdoktor.com/medicina-od...ina?format=pdf

I think you’ve still got plenty of time to get that urine culture done. If you drop off the sample tomorrow morning, you should have the results back by Friday.

Since bacterial infections can actually be passed down to the baby during delivery, it’s really important to figure out exactly which strain we're dealing with.

You should definitely give your gynecologist a call. I'm honestly not quite following their logic on why it would be "too late" to start therapy.
If you happen to have a gynecologist who’s actually going to be there to deliver your baby, go ahead and pick their brain. Get their take on everything.

Michelle Hughes17 said:I really need some help here. My due date is this Sunday, November 4th, but I just got my urine test results back today and they’ve got me pretty worried... I don't have an appointment with my doctor until Friday, so if anyone could help me make sense of these irregularities:

Urine appearance: cloudy
Urine color: dark yellow
pH level: 6.0 (5-9)
Specific gravity: >=1.030 (1.002-1.030)
Proteins: 0
Glucose: 0
Ketones: 0
Urobilinogen: 16.0 ( bilirubin: 0
Nitrites: 0
Erythrocytes/Hemoglobin: 0
Leukocyte esterase: approx 500 (0-10)😲
Leukocytes: high (0-2)
Erythrocytes: 3-5 (0-2)
Mucus: some
Bacteria: many
Squamous epithelial cells: some
Small epithelial cells: a few

Thanks so much!

Don't panic.
Give your doctor's office a call right away and read the results to them over the phone.

You didn't mention why you had the test done in the first place—are you dealing with any urinary tract issues, pain, burning, or a fever?

The leukocytes and erythrocytes usually point toward inflammation, which could be a UTI or just something from the vaginal area.

Since you're so close to your due date, it's also possible that your mucus plug is starting to break down, which often brings a little blood with it.

When a result shows "many" bacteria, doctors typically run a follow-up test before jumping straight to a full culture.

Casey Palmer5 said:a) I almost always hit up the two closest ones—one's a local independent shop and the other is a big chain. Honestly, I don't care which; the independent one usually carries stuff the big chains don't. Plus, at the private one, they actually remember if you're a doctor or just a regular customer. They even hand out cosmetic testers...
b) The service is fine. As for their expertise, I wouldn't say I've really tested it since I know exactly what I'm coming in for.
c) Not really, but I barely talk to them, so it’s not something I notice.
d) Just sell me what I need. I don't need a lecture; all the info I need is already on the Department of Health and Human Services website or just Google. When it comes to over-the-counter stuff, I'd prefer if they pulled out all the similar options so I can quietly check the ingredients myself...
e) Dealing with a hypochondriac ahead of me in line, or anyone else who needs more than five minutes of attention.
f) 6...

The only places getting a 10 from me are pharmacies in Thailand, Brazil, or Romania... they have that "big box retail" sales approach. It's not necessarily a good thing, but it just works for me...

Where would you even go if they started pulling all the same or similar medications off the shelves? 😁

Honestly, you can do just about everything from the comfort of your own couch. You can hop online, dig through all the ingredients and details yourself, and really get a handle on what you need. If you don't feel like you need to sit down for a formal consultation, you can just walk in, tell them exactly what you're looking for, and say, "Hey, give me this and that." It’s like ordering at a diner—once you know what you want, the whole thing is settled in a heartbeat.

Unless you really feel like you need some extra guidance, but honestly, that's what pharmacists are there for—to give you advice.

When I sit down with a patient, my main goal isn't just to listen—it's to really dig in and figure out if the medication they have in mind actually fits their specific health profile. Sometimes, what a person thinks they need might not be the most effective route, so I look for better alternatives that could work more efficiently for their unique situation.😉

Today is Pharmacist Day!
Ever wonder why we celebrate?

Have you noticed any special celebrations at your local pharmacy, and if so, how did they mark the occasion?

Sending my best wishes to everyone working in the pharmacy business—hope you all have a wonderful, smooth day at work!

Melissa James70 said:Fair enough, but isn't it actually better if you're the one sick working all day, rather than them being sick while you cover everything? It makes more sense for a healthy person to pull a full shift instead of someone pushing through while they're under the weather, which just ends up dragging their illness out for a whole week.

Would you seriously show up to work with a 102-degree fever?
And would you even wear a mask?

Have you ever actually walked into a CVS and seen anyone working behind the counter in a mask?
How are you supposed to talk to customers?
Besides, I’d need to wear a mask constantly just to protect myself!
With my Hašimoto-teratutura hitting 102, I’d barely survive, and honestly, I can't even remember the last time I ran a fever that high.

Trust me, pulling shifts at a pharmacy from 7 AM to 8 PM all by yourself is no walk in the park.
Maybe when you're ten years younger, it'll feel easier.
Look, my job is just a bit different in that regard.
Of course I agree that if you have a virus, you should stay home and rest for a day or two—mostly for your own sake, but also to look out for the rest of the team.😉

I end up calling in sick with some bug just so my coworker doesn't have to carry the entire workload by themselves.
It feels like I’m burning through my vacation days just to deal with these seasonal viruses every few days.
Besides, people tend to show up at my place when they're already feeling under the weather.

Don't get me wrong, I don't think showing up sick is ever the right move.

For me, the absolute worst part is when someone stands right next to me and lets out a massive cough.

Or even worse—when someone comes over, practically breathes all over me, and then follows it up with:"Hey, do you have anything for an upset stomach? Everyone at my house is sick!"

The only way people will actually start paying attention is if they have to pay out of pocket for their meds.
And honestly? Some folks might just skip their treatment altogether.

If someone’s pulling in a decent pension because of PTSD, they won't mind shelling out the cash to keep their prescription filled.

I don't see an easy fix here, even with all my years of work behind me.
To me, the answer looks like private insurance—you pay the full price upfront, and then the insurance company reimburses you.
But let's be real, that's not exactly how things work for most Americans.
Solidarity is a double-edged sword!!

Anyway, I'm heading out to grab coffee with a friend now... we'll stick to much lighter topics!!

The New York Times recently published some new regulations regarding medical record privacy and the protocols for prescribing and dispensing medication.

A pharmacist doesn't have access to a patient's full medical history, nor do they have any right to demand it from them.
If a patient comes in asking for Novocain and they choose to voluntarily show me their medical history, I might issue the medication provided they leave a deposit for the full price—though even that's a bit of a gray area legally speaking.
Sometimes, a doctor won't write out a formal prescription because they don't think the patient actually needs it, or maybe the ER staff just scribbled something down just to have something on paper. In those cases, we lack the necessary documentation—a valid private prescription—that we’re required to log in the pharmacy's official duplicate prescription book.
It also happens when a doctor prescribes a cheaper generic instead of the specific brand requested, which creates another headache for us.
If you try to call the doctor about it, you'll just hear, "Hey, you don't get to tell us which medications to prescribe!"

Our pharmacy has entire black trash bags filled with medication that patients bring back simply because it expired.
On top of that, the pharmacy is stuck footing the bill for the specialized disposal and destruction of all that stuff.
It's just one more expense we have to swallow.
And don't even get me started on the "difficult" patients who pick up their meds but never actually take them; they just need the paperwork to prove they're following a treatment plan so they don't lose their sick leave, disability benefits, or whatever else.

Kyle Lee7 said:I realize they followed protocol—but honestly, nothing would have changed even if she had listened to me. She could have just taken my ID as a guarantee. The only real consequence was that I wasted an extra hour or two wandering into the ER in the middle of the night while my bladder felt like it was on fire, just to get a prescription for the exact same medicine I’d already asked for—medicine I could have easily picked up the following day. Those two hours of misery meant two hours less of sleep, and I had a 6:00 AM drive out to Cleveland and a full day of field work ahead of me. 🙂

It used to be easier to get these things, but now the regulations have become incredibly strict. On one hand, I get it; people tend to pop pills left and right without any guidance, lending medications to friends, taking dosages incorrectly, or stopping treatments prematurely. If I recall correctly, there was even a recent report detailing how more than half of all prescribed medications end up being misused or discarded.

One other thing that really frustrates me—and this isn't about pharmacies—is that you can get a massive amount of medication on a prescription that almost anyone can afford and that isn't life-critical, yet we constantly see headlines about shortages for people battling cancer or other serious illnesses. You know, the ones who need it most. Shouldn't there be some sense of solidarity? Why can't people just pay out of pocket for their own nasal sprays or minor stuff? Or is the mindset that if someone is that sick, they’re going to die anyway, so why bother... ☕

You won't believe this, but we actually had a doctor call us up and threaten to report us for illegal practice. This was just for giving a long-term patient of ours—someone we've seen for ten years—his regular medication on credit.
The fine for the pharmacy is $100 $0.00, for the pharmacist it's $10 $0.00, and then you lose your license entirely.
Why would anyone risk their entire livelihood?
Basically, the doctor supposedly wrote an e-prescription, but it never hit the system, so it didn't even show up. We made an exception so the guy wouldn't have to stop his folic acid therapy, but then the doctor turned around and blamed us for her own mistake. It took her a whole month to realize what went wrong, and it was 100% on her.
Not to mention, she constantly claims her "internet isn't working." 😁
For heaven's sake, her internet "doesn't work," she doesn't check her entries, or she just forgets to write things down.

Just try telling a patient that they're getting too many meds on their prescription. 😛

It's hard enough for them to cover a few extra bucks since they already have supplemental insurance. 🙂

Kyle Lee7 said:a) Almost always, because they are in the building where I've lived since I was five years old. Everyone there knows me, and they're often willing to let me grab something without a prescription upfront because they KNOW I'll bring the script by the next day (this obviously applies to my regular medications; they wouldn't just hand me something totally new if I walked in asking for it for the first time).
b) Yes
c) Huh? I mean, shouldn't everyone working there have completed pharmacy school?
d) Quick and clear advice/recommendations, but above all, I just want them to have what I came in for.
e) Waiting in line, especially during flu season, or when they don't have my specific medication in stock.
f) A 9, refer to point e.

As for other pharmacies, I've had both great and somewhat less-than-great experiences.

There was this one pharmacy on an island we visit; the woman was incredibly friendly and eager to help, but her final advice was actually *not* to go to the clinic, even though my condition was clearly worsening. She had this negative view that they’d just jab me with injections that she claimed were "very harmful." Look, lady, I know they carry risks, but I also know my medical history makes me a chronic patient, and I wasn't about to gamble with an allergic reaction to an insect sting that might pass in three days for someone else but could land me in the hospital.

On the flip side, I had a wonderful experience with a pharmacy in Ozalj. After two or three different places told me the product I needed was out of stock due to a shortage, I called them. A very kind woman (her name is Jane, and I'd like to thank her again here) took it upon herself to call around for me. She quickly found out where they had it in stock and even offered to order it for me so it would be ready tomorrow morning if I couldn't make it in.

Third example: a late-night emergency pharmacy. I was losing my mind from a bladder infection, having just arrived back from a trip, and I already had to head back out at six in the morning. It wasn't my first time dealing with this, so I knew exactly what I needed. I told the woman just to give me the meds—that I'd leave any ID (driver's license, credit card, insurance card, whatever) and bring the prescription in later. But it was a hard "no." No, no, and no. I had to go to the ER. Okay, I get that they have strict rules, but I was dead tired in the middle of the night and had to go to the ER, wake up the doctor on call who gave me a pale look for waking him up over a bladder infection, wait for him to scribble a script and go back to sleep, and then I had to head right back to the pharmacy to get... that.

In most pharmacies, you’ll also find pharmacy technicians who have completed high school.
I wonder if a patient or customer can actually tell the difference in terms of service, knowledge, or expertise between the staff helping them.
Unfortunately, there are still some pharmacies out there where a technician is running a shift entirely on their own, which is against the law.
On the bright side, there are plenty of techs who are so skilled and knowledgeable that they handle much of the patient interaction just as well as anyone else.

Regarding pharmacists stepping in on a doctor's decision—honestly, sometimes it's absolutely necessary.
The trick is knowing how to communicate it so the patient stays safe and the doctor doesn't feel undermined.
It really comes down to being balanced and having solid communication skills.
That takes a lot of patience and finesse. To be fair, we're all different, and it isn't always easy to stay tactful while balancing a doctor's orders against a patient's wishes.
A pharmacist has to be able to judge that fine line between a minor issue and a serious health concern where the patient definitely needs to see a doctor.
We don't exactly love it when clinic staff meddle in our business either, telling patients "just buy it at the pharmacy, you don't even need a prescription anyway" without checking the dispensing rules first. For anything under a prescription regimen, a private prescription is mandatory.

As for that bladder infection case you mentioned—during an after-hours shift, a pharmacist is only authorized to dispense medication if the prescription is marked as urgent.
The pharmacy actually did the right thing here.
To avoid this headache next time, just ask your doctor for a private prescription without a date on it. That way, you won't have to try and explain things or play games at the pharmacy window.😉

melloworca6 said:I disagree. 🙂

I know plenty of cases where GPs messed up and wrote down a slightly higher dose—like, just a tiny bit off, what's the big deal, right? 😁 But then the ladies at the pharmacy 😁 catch the mistake, tell the patient, call the doctor, and fix the dosage. So, honestly, sometimes those clerks 😬 are actually saving lives.

Though, being a doctor, you probably already know all this and you're just being difficult now. 😁

Of course they're just messing with you.😉
He just loves to stir the pot, all while hiding behind his wife's username. 🙂

That final check before a prescription actually gets filled? It’s honestly such a critical step.

Say, imagine a patient walks in holding a prescription for Amoxicillin. Anyone here deal with a penicillin allergy? So, I was just sitting here thinking... what's on your mind? Yeah, I am—my insurance card says so right here. It works for him.
It felt like my doctor was a little bit out of it when she was writing that prescription.☕

It uses a stevia-based sweetener, which means that sweet aftertaste tends to linger on your palate a bit longer.

I’ll check back on Monday to see if we can pull this through via emergency import

Kate Collins67 said:I mean, look—you’re standing there behind the counter, right? You're basically running a sales pitch every single second you're on the clock. It’s easy enough to lose your footing when you're constantly being pushed to move product... honestly, anyone could get tripped up in that situation.

You're oversimplifying things.😉

A good pharmacist does more than just ring things up; they offer guidance and education while taking full responsibility for what they say. 😁

And we aren't just talking about a retail transaction here—we're talking about clinical expertise and prescriptions. 😁

Which medication are you talking about? Please list the exact brand name and its main active ingredient.

Regarding the whole topic of pain medication, I came across this one line: "the pharmacist at the drugstore told me...

It really makes you wonder—why is there this perception that we’re just retail clerks?

Their whole purpose isn't actually to fix your vision or improve your prescription, but rather to help prevent macular degeneration from taking hold.

Give this a read

http://www.yourhealth.com/edition/article/914/

Tyler James5 said:You've got a point there—I agree that tech shouldn't slow the process down, and for the most part, it doesn't. There are about eight pharmacists working across three nearby pharmacies around here, and I only ever have issues with one of them. So yeah, the majority are totally fine.

Btw—if a patient shows up late and can't get their medication, just don't give it to them. There’s zero point or benefit in wasting six minutes arguing. It's just more efficient this way.

...

If someone misses the window to pick up their medication, we have to explain that they can't get it and need to contact their doctor for a new script.
I agree, you definitely don't need a six-minute lecture for that.
Some people get it right away, while others will never quite wrap their heads around it.
They call the clinic, and the doctor says, "Oh, you have a refill on file."
Then the patient goes, "But the pharmacy wouldn't let me have it!"
It isn't our choice; we're just following the rules.

vividsailor7 thanks for breaking that down point by point.

melloworca6 Cough syrups, nasal drops, teas, sprays, cosmetics—none of those are subject to margin regulations.
Basically, every pharmacy has total freedom to set their own prices on those.
Most often, the margin sits around 35%, and the final price might even be dictated by the manufacturer or distributor (like McKesson) just to ensure their products cost the same across all pharmacies.
Only actual medications fall under differentiated margins—meaning anything listed in the drug registry, whether herbal or synthetic, that is restricted to pharmacies (which is what Medicare regulates).
Here, the tax on drugs is 25%except for those covered by Medicare, which aren't subject to sales tax, making them relatively more expensive here than in neighboring countries.

Tyler James5 said:I gotta admit, I’ve started dodging my local pharmacy altogether. Not because of the medicine, but because the pharmacist there has given me this long, drawn-out, painfully slow lecture—for the third time now—about exactly which day of the month I’m allowed to pick up my prescriptions. It’s like they think repeating the same thing over and over makes things more efficient, but honestly, it just kills the line... And when you consider that some chronic meds cover 28 days, others 30, or even 20, plus I’m picking up stuff for three different family members... then if the doctor gets a dosage slightly off... I still have to sit there and take this whole sermon while being totally powerless to change anything...

And don't even get me started on e-prescriptions. 🤦 It’s wild how much "modern technology" can actually grind an entire system to a halt.

And no, it's not even a universal problem. If I go to other pharmacies, they don't play these games. They give me what they can, and if they can't, I just call the doctor for a new script and move on. In and out in two minutes, easy.

...

Technology hasn't slowed things down at all.
People seem to forget how messy it was back when paper prescriptions expired and you had to trek back to the doctor, wait again, and then head back to the pharmacy.

Patients get annoyed when we're late because of the lectures,
but we get annoyed when people don't pay attention to when they should be picking up their meds,
leaving them without their very last pill,
then begging us to "lend" them a few doses early,
or we have to call them because they forgot to mention their new script was ready.
We shouldn't have to constantly repeat that everything is clearly stated on the
refill authorization (you can pick it up 7 days before or 14 days after the date listed).😁

But hey, that's just part of the job.

melloworca6 said:I don't know the exact percentage, but I know there are massive differences between pharmacies, which means their margins aren't all the same.

Take beta glucan, for instance. I paid $120 at the pharmacy you told me was the cheapest one, but then a friend of mine found the exact same thing at another shop for about $150. It’s the same story with everything from eye drops—where the gap isn't quite as huge, but it's still there—to just about anything else. It makes sense that there are both state-run and private ones, and sure, private shops can charge whatever they want, but I was genuinely shocked by a price gap that big.

edit: Just remembered. I actually found that same beta glucan online recently for $77 with free shipping, when the standard price is usually $87. Honestly, I have no clue how these people justify charging $150.

The same regulations and laws apply to both private and public pharmacies.
It doesn't necessarily mean they don't have the same margin. It's more likely they just aren't using the same supplier.
Since beta glucan isn't classified as a prescription drug, it isn't subject to those specific differentiated margins required by the pharmacy board. Every pharmacy is free to set its own markup, though it never goes over 35% of the wholesale cost.
If someone doesn't want to make a profit, well, I don't see much point in them being in business at all.
Nobody is required to justify their pricing, but they probably won't sell much at $150.

Yeah, the price online is without shipping, but once you factor in the cost of the beta glucan, you end up right back where you started.