Posts by swiftbear86

velvetmoose9 said:Fair point! 👍

In my line of work, my main goal is just being honest and responsible to my patients (even the difficult ones).

I’m not one of those people who lives to push sales, so don't worry about that.😉

I often find myself telling them, "You actually don''t need this," and they just laugh at me because they're like, "Hey, I've already got something similar sitting in my cabinet at home!!"

feralmarlin23 said:It isn’t just about Sumamed; it’s practically every single pill! Everything is out of stock, and they immediately push some substitute on you. There's no Zoloft, no Peptoran 150 (though they have a replacement ready right away), no Contralock (again, an immediate substitute), and it goes on like that for almost everything. They offer a replacement instantly, but if you want the actual brand, you have to wait until the second day. Now, I live close enough that I can just wait a day, but try explaining that to my elderly parents! If it's urgent, they'd rather drive 40 miles to a different pharmacy than deal with a substitute, or else they'll just take whatever is available right now to avoid the trip. This pharmacy has turned into nothing more than a place to hand out generics. And heaven forbid you actually complain—you'll be met with an immediate threat of a defamation lawsuit!

Man, I totally get where you're coming from and what you're trying to say.😉
That pharmacy has clearly gotten a bit too comfortable because they think they can get away with it.

It doesn't cost you a dime to file an anonymous tip with Medicare. Once they look into the pharmacy's books—or just cross-reference what the doctor wrote on the prescription against what was actually dispensed at that location—they'll see exactly what kind of game is being played.

It’s definitely about those profit margins...
I get why the pharmacy does it, though. While they're waiting for Medicare to pay them back over the course 300 days, getting that bulk discount from a specific manufacturer is pretty much their only guaranteed way to make money.

As for them suing you for defamation? Honestly, you can always write your complaint in their official grievance book, though I know people rarely bother with that.
You could also ask to speak with the manager and give them your two cents, but I realize that isn't always the easiest route to take.

Another option is the IRS—always keep your receipts, especially the ones showing what you paid $0.00, and double-check that they're properly registered sales slips.

You can also ask them to print out the list of prescriptions your doctor wrote before they process them. That way, if they swap your medication for a generic, it shows up clearly on the receipt after it's been filed.

Then you've got proof: the doctor ordered one thing, but your receipt says another.
Do that a few times, and you've got a paper trail.
Take those documents to Medicare, the medical board, or the Department of Health and Human Services...
There are plenty of ways to handle it, I just don't know if it's worth the headache and the stress for you.
Your best bet is probably just to insist they get the exact medicine written on the script!
Or, you could mention to your doctor that this specific pharmacy keeps swapping your meds; maybe they can reach out and put some pressure on them!!

velvetmoose9 said:I've been thinking about that Ectoin lately too, but honestly, I just haven't seen enough solid feedback yet to really form a decent opinion on using it as an adjuvant therapy.

It’s going to take a little while to get any real reviews since the spray has only been on shelves for two weeks!

I’m not the type to jump on a bandwagon and call something "amazing" unless I’ve tried it myself or my family has, but right now, this seems like our only real option. It's priced at about $20, whereas last year we could grab the Nasya spray at the pharmacy for $33. That’s quite a jump—enough to make someone really hesitate before giving it a shot.😉

The thing with Nasaleez is that it’s a bit awkward to use. It looks pretty unappealing because you end up with stuff dripping out of your nose, making you look like you’ve been snorting something else entirely.😉

Tyler James5 said:I’m definitely gonna look into that tomorrow 👍 (a few years back I tried that Nisita nasal ointment for the same thing, but the lemon oil they put in it was driving me crazy... probably just to make it smell better, I guess)

thanks for the tip, swiftbear86

...

For me, Nisita ointment is a total lifesaver when the AC starts drying out my nasal passages, whether I'm at the office or mostly just hanging out in the car.

There used to be a white powder version of Nasaleez available, but you can't find it anymore, so this spray looks like a solid alternative.
My kid deals with allergies to grass, weeds, trees, and bushes, and that Nasaleez was a huge help. We'll give this Ectoin a shot, too.

feralmarlin23 said:Not only do they hand them out, but they actually go out of their way to call the pharmacy or the nurse just to get the substitution updated!

So, what's the big deal, anyway?

Look, if the doctor insists that it absolutely has to be Sumamed, then fine—let them go ahead and order it themselves.

It’s honestly such a bummer when my sister has to switch up her medication, and then the pharmacist isn't even allowed to offer her the exact same thing. It just feels like an unnecessary hurdle.

Nah, I don't think that's quite what you meant...😉

So, I was thinking about this the other day. When we run out of a specific medication and have to call the doctor—you know, calling the actual physician rather than just checking in with a nurse—do they usually just tell us to use whatever we have left in the cabinet, or are they strict about needing that exact brand or dosage written down? Sometimes, if there’s another pharmacy just a few blocks away, the doctor might even suggest taking a little stroll to go find the specific one they prescribed instead of just settling.
We might actually see that medication hit the shelves by tomorrow afternoon, but honestly, that’s a total fluke. Usually, you're looking at much longer waits. We always seem to have Sumamed on hand around here.🙂

jadeviper9 said:I've been wrestling with allergies for about 7 or 8 years now, and every time spring rolls around, it feels like an absolute explosion inside my body. I'm allergic to basically every type of grass and dust under the sun. For the last few seasons, I’ve just been cycling through Aerius, Flixonase, and some random eye drops. But yesterday, I switched things up—took the Aerius and tried this new Avamys spray. It seems like things have finally settled down since last night, though, if my past experience holds true, it usually takes two or three days for my system to actually mount a defense. And God forbid I miss even a single day of the spray or the Aerius. Everyone raves about how great Avamys is, but honestly? Just be prepared to pay through the nose for both medications.

Try using this to help block allergens from traveling through your nose into your airways.

You can use it alongside Avamys if you wait about an hour between applications.

melloworca6 said:Look, it doesn't matter what side you're on, you can't deny things look shady when this kind of stuff keeps happening. If a doctor writes a specific prescription and they just insist on pushing some substitute—and then turn around and attack anyone who dares to push back—something smells fishy to me. 🤷

It’s definitely possible that there's an odor involved, too.😁

But look, if your doctor actually writes it right there on the prescription... Look, if they tell you that you aren't allowed to switch up a prescribed medication, then you're stuck. It’s not even a choice at that point—the software simply won't let me make the change. .

Look, I get it. If you’re living out in a tiny rural town or some small village where there's only one pharmacy for miles, you basically have to take whatever they've got on the shelf. I'm definitely not saying that's okay or making excuses for it, but I can certainly understand why someone would feel stuck. When you don't have options, you don't really have a choice.☕

There’s actually a specific set of federal regulations regarding how prescriptions are written and filled.

http://www.medicare.gov/regulations/pharmacy_guidelines_example.pdf

Article 15 provides a breakdown of how this works.

Article 15.a
(1) Unless the doctor specifies otherwise on the prescription, the pharmacy can issue a single
original package of the lowest strength medication available.
(2) If a pharmacy doesn't have the exact medication prescribed, they are required to get it in
for the patient within 3 days at the latest, or ensure the patient can pick it up at another pharmacy.
(3) For refillable prescriptions, the medication is usually dispensed at the same pharmacy, unless it’s an
e-prescription, in which case the patient can go to any participating pharmacy.
(4) As an exception to Article 15, sections 1 and 2, if a pharmacy—during
the first fill or a refill of a recurring prescription—doesn't have the specific
brand in stock due to a shortage in the United States, the pharmacist has the right, without needing to
check with the prescribing doctor first, to provide the patient with a generic version of the same type at an equal or lower price from the approved list,
provided the doctor didn't explicitly write "no substitutions" on the script, and provided that
the patient agrees to the switch.
(5) When such a substitution happens under section 4, the pharmacist is required to note it on the prescription during
the initial fill, or update the electronic record for refills of
recurring prescriptions.
(6) If the patient refuses the generic alternative, the pharmacist will, during the initial fill,
return the prescription and send the patient back to their doctor to get a different one; for an e-prescription,
they'll direct the patient back to the doctor who issued the electronic order. If a patient
refuses the substitute during a refill request for a
recurring prescription, the pharmacist will close out the electronic record and refer the patient back to the
prescribing physician to adjust the prescription accordingly.
(7) If the doctor marks it for "refill..."

Pharmacies have to balance their business operations with keeping customers happy.

Look, it's just not realistic or necessary for a pharmacy to keep every single medication on the list in stock.
They stock what they know they can reliably dispense quickly without having inventory sitting on the shelves for months.

Usually, that means the common stuff doctors prescribe most often, which is easy to have on hand.
Considering how long it takes Medicare to reimburse pharmacies for what they dispense (sometimes up to 300 days!!!!), it’s honestly a miracle pharmacies even stay in business.

Doctors also need to keep an eye on the cost when they're writing these scripts.
Sumamed is definitely one of the pricier macrolides, yet doctors often just write down a generic like Azithromycin (which could be Sandoz or Belupo...) without ever mentioning the price difference to the patient.
When the patient walks into the pharmacy, they feel blindsided, like we're trying to pull a fast one on them.
Luckily, with e-prescriptions, we can show the patient a simplified version.
If they aren't happy with it, we usually just send them back to the doctor so they can work it out.
Patients often end up venting their frustration at the pharmacist while staying perfectly quiet with the doctor.
Then, once they get home and call the doctor, and the doctor says, "Well, that was Sumamed," suddenly everything is fine and they're happy again.

But honestly, it seems to me that the situation mentioned above isn't really about anything shady; it's just standard pharmacy procedure.
Basically, the script says Sumamed, they don't have it, so they offer a generic (per the rules) or tell the patient they'll order it for tomorrow.
That is completely standard practice.
I realize that doesn't make it any less frustrating for the patient, though.
If you suspect anything shady going on with how a pharmacy is running its business, you can file a report with the local Chamber of Commerce, Medicare, or the Department of Health and Human Services...

As for Concor, they’re still manufacturing it, but honestly, shortages happen all the time—and it’s not just with that one drug.

Someone mentioned an alternative AP up above without actually naming which one. Those tend to run out quite often too.
Veli visited the exact same pharmacy three times, so she's moving on now..
It happens to us more often than you'd think: a patient comes in, we don't have what they need, we order it for tomorrow, and then they just never show up. We end up putting the medication back on the shelf because why bother letting it sit there and take up space? Then, three months later, the same person walks in and claims we *never* have it in stock. If they had just come by the next day like they said they would, we'd know they were a regular, and we would've made sure to have it ready for them next month.

Ashley Martin78 said:I just got my thyroid blood work back

T3 1.60
T4 108
TSH 4.18

What does this mean?

Basically, these hormone levels look pretty normal to me.
Your doctor will probably want to recheck that TSH level in a little while.
At the end of the day, an endocrinologist will make the call based on your full health picture.

If you want to dig deeper into how thyroid hormones and TSH actually work, check out these Mayo Clinic pages:

http://www.mayoclinic.org/thyroid-stimulating-hormone.html

http://www.mayoclinic.org/thyroxine.html

http://www.mayoclinic.org/triiodothyronine.html

You can also find more info in our dedicated thyroid discussion thread here:

http://www.reddit.com/r/thyroid/

Benjamin Martin65 said:😲

I remember a time when a friend of mine—who was only about twelve years old at the time and had actually just gone in because of some minor acne—was told by a general practitioner that she had PCOS, just based on a quick glance at her. The doctor went on to tell her that yes, it was clearly visible, that she would remain infertile because of it, that she’d never have children, and that she absolutely had to see a specialist immediately for an urgent consultation. The poor girl ran home in a complete state of panic to her mother, who then had to go back to that doctor's office to have a serious word with her. I truly believe 🙄

So, did she actually end up getting an official PCOS diagnosis back then, or even now?

Timothy Lee29 said:I couldn't seem to track down the right thread for this, so I'm asking the admin to please move this post to the correct spot or just point me in the right direction.
I’ve been wondering how I can actually request a prescription online through my primary care doctor. I already know the drill when it comes to booking hospital appointments or scheduling follow-ups, but I can't seem to find the specific option to just message them about a refill or a new script. It would be so much easier if I could just send a quick note and have everything ready to pick up by the next day. Does anyone know how this works? Thanks! 😉

You really need to sit down and have a serious talk with whichever doctor is writing those prescriptions for you.
Is it actually common practice for patients to just send an email to book their appointments? When you're dealing with a chronic treatment plan, it really changes your whole rhythm. It’s not just about taking a pill once in a while; it becomes this constant, underlying hum in the background of your life. You start planning your entire day—your meals, your sleep, even your travel—around that one specific routine. It’s like having a second job that you never applied for, but you have to show up for every single day without fail. Then they’ll probably just hand over their email address to you.
If you don't have an email address to work with, you're basically stuck with two options: giving them a call or just showing up at the doctor's office in person.

rowdyraven3 said:I was there—because of my husband, his close friends, and all that—but I still can't quite shake the disappointment. 😢
Since we were going to buy a gift anyway, we wanted something memorable, especially since it was for a girl (and it was her Confirmation, not her First Communion 🙂) who's eleven. We decided on a wristwatch... my husband left the picking to me... we looked at prices, and let me tell you, my head was spinning because you can't find anything decent under $133 so we found one by $197 — Paris Hilton—and I thought, hey, she's a teenager, she loves that stuff, she follows the trends, so we'll go with something pinkish...

I went in all happy, feeling pretty proud, expecting her to at least open it and look thrilled... (for me, the best part of giving is actually nailing the perfect gift) but... the little girl just made this sour face. How do I even describe that feeling? It was like she thought I'd picked it up at a flea market for like ten bucks... 😢 Then her mom mentioned she’d "outgrown" the color pink, and honestly, my heart just sank...

We're heading back tomorrow to swap it for a different color 😢 and believe me, I am absolutely mortified having to tell the clerk, "Could you please lower the price?" because we acted like we were short on cash and the clerk forgot to take the discount off... it was just awful...

At 11 years old, she wouldn't be having her First Communion 😉 It’s either First Communion or she's older than 11.

I totally get why you're bummed, but if she's over the pink stage, going with a neutral color is definitely the smartest move.
It's tough trying to pick out something special for a kid when you know them well—it's even harder when you don't. You'll save yourself the headache and the stress by just giving them the cash (I'm a big believer in "keepsake gifts" myself) and letting them pick out whatever they actually find cool.😁

jadetrucker43 said:Did it ever cross your mind to just hit Print Screen and then paste it into Paint? 🙂

Fair point... but that just saves the image to your PC.
Then you still have to go through the hassle of uploading it to a site like Imgur just to get it to show up here. I don't see how that actually saves any time, unless I'm totally missing something?



http://www.youtube.com/watch?feature...&v=U37MTd5QiyI

restlessbear34 said:Yeah, exactly... so if I want to "snap a picture" of this spot and share it here, how do I actually do that? 🙂

Here’s how I managed to make that top link work:

I opened up Google Earth
found the exact spot
then, in that top toolbar—right by where the little pin icon is at the end—you'll see a tiny preview icon for Google Maps
I just clicked that icon
it opens up a brand new tab with Google Maps
from there, you just grab the URL from the address bar and paste it right here on the forum

https://maps.google.com/?ll=45.81289...mid=1364159137

There's probably an even easier way to go about it, but honestly, I haven't figured that one out yet.

Quote:Quote:

restlessbear34 says: Is there a way to, say, "screenshot" a spot on Google Earth and then upload that image to the forum? Also, how can I mark a specific location on that same image so someone else knows exactly what I'm pointing out? Thanks... 😉

Are you thinking of something like this?

https://maps.google.com/?ll=45.81208...mid=1364150474

In Earth, there’s an icon to view a Google Map—it's the very last icon on the top toolbar (if

Bryan Evans77 said:No worries at all, swiftbear86! Happy to help.

So, basically, that first guy works by gathering all those possible quotes and bundling them together. Then, clicking the quote actually triggers a brand-new thread that contains every single one of the quotes he picked out.

I really hope I can pull this off...😛

Samuel Torres30 said:You really shouldn't mix up File Explorer with Internet Explorer—honestly, if I had the choice, I’d delete Internet Explorer from my computer forever. I only mentioned it because I thought it might save you some hassle, so you wouldn't have to go digging through a dedicated photo editor or anything like that. Once you've saved your image (it usually lands right in your Downloads folder), just close out of your browser or minimize it, click on the file to select it, and then follow the steps I laid out. Here’s an example using this specific photo to show you exactly what I mean:
I can't see the image you linked, but if you're trying to show me a screenshot or some kind of error message, go ahead and describe what’s happening on your screen. Just walk me through it like we're sitting at a coffee shop—what were you doing right before things went sideways? Once I have a better idea of the situation, I'll do my best to help you troubleshoot.
I honestly can't think of anything that could be any simpler than this.

My bad, I was thinking of Internet Explorer too. 😁
I gave your method a shot, and man, it really is that simple. It’s a total lifesaver for anyone who isn't lugging around a bunch of heavy-duty photo editing software—even though most people probably have something like Photoshop installed these days.

Thanks so much to both of you.🙂

Bryan Evans77 said:Just right-click and hit "save image as"—then you can just tuck it away wherever you want.
Once you've got that, just pop it into Photoshop or whatever editing software you prefer—I usually just pull mine straight into Lightroom. From there, go ahead and import it into Lightroom so you can check out all the metadata.
The owner is Ms. M. S.-N.
So, I was playing around with my settings earlier—shooting at 1/1600 at f/7.1—and it got me thinking about how much those little numbers actually dictate the whole vibe of a shot. It’s kind of like adjusting the seasoning in a soup; if you get the balance just right, everything clicks, but if you miss, the whole thing feels off.
Thinking about switching to a 200mm focal length? It’s kind of like moving from a wide-angle lens that captures the whole neighborhood to one that just zooms in on that one specific house you're interested in. You lose all that extra context around the edges, but man, the detail you get on your subject is something else. When you're shooting at 200mm, everything feels much more intimate. If you're out in a place like Central Park, you aren't just taking a photo of "the park" anymore; you're capturing the expression on a kid's face or the way the light hits a single leaf on a tree. It forces you to be much more intentional about what actually belongs in your frame. You can't just stand back and let everything happen; you have to hunt for those moments. Just a heads-up though—it's a bit more demanding than your standard kit lens. Since you're zooming in so far, any little shake from your hands is going to look like an earthquake in the final shot. I usually find myself leaning against a lamp post or using a tripod if I want things to stay sharp. Also, keep an eye on your shutter speed; you'll want to keep it fast enough so your photos don't end up looking like a blurry mess. It takes a little practice to get used to the tight framing, but once it clicks, it's a total game changer for your photography.
Captured on August 5, 2011.
So, I was out playing around with my Pentax K-X the other day. I decided to try shooting at ISO 400 without using any flash, just to see how the sensor would handle things. It’s one of those little experiments that makes you realize how much the lighting situation really dictates the vibe of a shot.
It’s one of those gray areas where you just aren't quite sure where you stand. It’s like walking into a store and seeing an item without a price tag—you want it, but you have no idea if it's actually available or if there's some hidden catch that makes it off-limits. You're basically flying blind on whether you can legally use it or if you're stepping into a legal minefield.

Alright...
Now I can finally track down all the info I need.
I really appreciate you keeping this between us.
When I was uploading that photo, it didn't even cross my mind...
I was actually hoping there might be a quicker way to pull up all the data on the forum.

Carol Watson83
I’m looking at the properties in Internet Explorer, and all I'm seeing is the General tab. There aren't any other details or options showing up for me.
Most of my day is spent working inside Google Chrome.

Thanks for all the input, everyone.🙂

Alright, here’s another one for you guys...
It looks like I can't figure out how to squeeze two different quotes into a single post.😉
If you're up for it, I'd love for someone to walk me through this. Thanks!

Is there a way to check the EXIF data for a photo that's been posted on this forum?

For example, take this shot of mine here:

http://img27.imageshack.us/img27/2408/abaclopo.jpg

Did you just want the link, or would you rather have the image pop up right here?

analogseal18 said:It simply won't happen. That’s exactly how certain principals used to operate—cutting corners just to see themselves promoted, essentially. The minimum point threshold remains fixed, regardless of how many students actually show interest in a specific major.
(If you ask me, the bar is already set far too low as it stands.)

I have a question regarding those extra credit points awarded for completing music school. Up until now, you could earn them for four years of study, but now I'm seeing conflicting info—some places say six years, while others just require completion of the program. I'm asking because my daughter won't hit that six-year mark, though she will be enrolled in an accelerated program to finish her music studies concurrently with her standard middle school curriculum.

My daughter was also on the accelerated track during 3rd and 4th grade.
She’ll still receive a certificate showing she completed elementary music school.
Just keep in mind that "elementary music school" implies finishing all 6 grades, not just playing an instrument for 6 years.😉
Even back in the day, you didn't get a diploma after year four, but you definitely used to get those extra points for the application process after finishing the 4th year.